Account Activation Form

First, please read our terms and conditions by clicking here:
(The terms and conditions will open in a new window)

I have read and agree with the terms of the MichUSA.Com service:

First Name: Last Name:
Company Name (if applicable)
Daytime Phone Number: Evening Phone Number:
Street Address (including apartment or suite number):
City: State: Zip Code:

What type of service plan would you like to purchase?

Standard Dial-Up:
Please note that all accounts have a one time $20 activation fee.
Monthly ($16 + $20 = $36) 6 Month ($14/mo + $20 = $104) Annual ($11/mo + $20 = $152)

Your desired login name:
(Login names must be between three and eight characters in length, must consist only of lowercase letters and numbers, and must begin with a letter.)

Your desired password:
(Valid passwords must be between four and eight characters in length and cannot contain spaces.)

Additional Email Accounts:
Monthly ($5) 6 Month ($4/mo x 6 months = $24) Annual ($3/mo x 12 months = $36)
Email Address: (no more than 12 characters) Password:
Email Address: (no more than 12 characters) Password:
Email Address: (no more than 12 characters) Password:
Email Address: (no more than 12 characters) Password:

Please select the type of computer and operating system are you using?

Who referred you to MichUSA?
Are you currently using an internet service? If yes, which ISP?

Method of payment: Credit Card Check or money order
Card Number: Expiration Date: (mm/yy)
Name which appears on the card:

Please make checks or money orders payable to:
Standard Data Systems
21042 Laurelwood St.
Farmington, MI 48336-5052



Have some questions? Send email to sales@michusa.com
For more information call (248) 478-4300
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