Contact Information

Preferred contact method:
Postal Mail | Telephone | E-mail

Contact phone:
Fax:
Contact E-mail:
* You MUST enter either a phone number (with or without fax number) or an E-mail address in case we need to contact you.

Organization Information

Is your organization a registered 501(c)3 non-profit?
Yes | No
* Note: it is necessary that your organization be registered as a 501(c)3 non-profit. Before your application can be fully processed, you will be asked to fax or mail proof of your 501(c)3 status to the FreeNet.

Your federal tax ID:

Your Current Internet Presence

If so, what is its address?

Do you have an existing dial-up Internet connection (e.g., an Erols or AOL account) that you can use?
Yes | No
* Note: The ServInt FreeNet does NOT provide dial-up Internet access. If you need it, we can recommend other providers to you.

Your Service With The ServInt FreeNet

You may wish to have a domain name registered for your website at cost of registrar service (e.g., http://www.yourorganization.com). However, this is not necessary, and if you do not wish to register a domain name, your site will be accessed as part of the FreeNet (e.g., your web address will be http://www.servintfree.net/yourorganization).

Will you want to register a domain name to access your site with (e.g., http://www.yourorganization.com)?
Yes | No

If so, what is your first choice for a domain name?

What is your second choice for a domain name?

* NOTE: If you choose to have a domain name, you will be charged $70 by Network Solutions, the organization responsible for domain registration. Additionally, you will be expected to abide by Network Solutions' own terms and conditions. ServInt is not responsible for charging this fee or dictating these terms and conditions of domain name service.

If you already have an existing domain name, do you authorize ServInt FreeNet to transfer your Domain Name Service to us?
Yes | No | Don't Know
* Note: Transferring your domain name service to ServInt FreeNet may disrupt Internet access if you use your existing domain for Internet access as well as web hosting. For example, if you organization has a leased line or DSL connection to your location which uses this domain name to refer to a local mail server at your location, transferring DNS may interrupt your mail service. If this is the case and you select "No," we will contact you about leaving your Domain Name Service in the care of your existing ISP and have them transfer only the webhosting domain record to ServInt FreeNet.

If you are unsure about whether to say "Yes" or "No" to this question, please select "Don't Know" above and describe your hosting/access setup below and we can assist you in deciding whether to transfer Domain Name Service:

If you have not elected to select a domain name and would rather have your site accessed with a FreeNet address (e.g., http://www.servintfree.net/yourorganization, please enter that address below:

Do you need Microsoft FrontPage extensions installed for your site?
Yes | No
PLEASE READ: FrontPage is not recommended as a web development platform because of its difficulties in support. Please be aware that we offer NO guarantees of technical support for FrontPage. Additionally, if you select FrontPage, you will NOT be able to receive other site features, such as secure server access or MYSQL database functionality. No exceptions.

Do you need telnet or SSH access to your site?
Yes | No

Do you need secure server (encrypted to make it safe to submit credit card numbers or other sensitive information) access for your site?
Yes | No

Do you need MySQL database access for your site?
Yes | No

Are you aware of any special needs that your site has (e.g., special database software, streaming audio/video, etc.)? If so, what are these needs?
None

Login Name and Password

Your password should be between 4 and 8 characters, and cannot include spaces. It must include either at least one number (e.g., bobby5) or one capitalization change (e.g., Bobby), or both (boBBy5). What would you like to use as your password?

Your application will be processed within 24 to 48 hours upon receipt. Thank you for your interest in FreeNet!