Name:
Address:
City:
Zip:
Current Email:
Phone(Please include area code):
Fax(Please include area code):

How did you find out about RAIN?: Through a search engine (IE: Yahoo, Excite, Infoseek) Phone Book Mailer Referred by another RAIN member. Please specify below. Referred by add in paper. Please specify below. Referred by Organizational Reference. Please specify down below. Referred by Other. Please specify down below.
Name/Email address of RAIN member:
Name of Newspaper/Newsletter:
Name of Organizational Reference:
Other type of Referral:
Type of Account: Individual ($15/mo.) Family ($25/mo) Business($25/mo, $50 startup) Non-Profit($20/mo) Camp Internet for the Family ($295/year)
Type of computer system you use: Windows XP Windows Vista Windows NT Windows ME Windows 2000 Windows XP home or professional Macintosh OS 7.6 up Macintosh OS 7.5 down Macintosh OS 10.x Unix/Linux Tablet Computer
E-Mail Address (username) you would like (3-8 characters, letters and numbers only):
Password you would like (6-8 characters, non-dictionary word):

If interested in an automatic debit/payment system, please look into our Auto-Bill feature. After filling out this form and signing, please either fax it to (805)899-2823, or snail mail it to us at: RAIN Community Internet
PO Box 325
Buellton,CA. 93427

Type of Credit Card: Visa Mastercard American Express
Credit Card Number:
Expiration Date:

Thank you for your support of RAIN's Public Internet Broadcasting Network!