Name:
CocoNet E-Mail:
Phone Number:
Computer/CPU Type:	-Select one- Celeron Pentium III Pentium II AMD K6/K6-2/K6-3/Athlon 386 486 Pentium PC Laptop Macintosh (non Power PC) Macintosh PowerPC Macintosh PowerBook Other (describe below)
Memory (RAM):	-Select one- 4 MB 8 MB 16 MB 32 MB 64 MB 128 MB over 128 MB
Operating System:	-Select one- Windows 98 Windows 95 Windows NT Windows 3.x Windows 2000 Windows ME (Millenium) Macintosh 7.x Macintosh 7.5.x Macintosh 7.5.2 Macintosh 7.5.3 Macintosh 7.6.x Macintosh 8.x Other (describe below)
Modem Brand:
Modem Speed:	-Select one- V.90/56Kbps 28.8Kbps K56Flex or x2 14.4Kbps 33.6Kbps 28.8Kbps ISDN Frame Relay
Dial-up Number:
Question:	-Select one- CocoNet Web Site Question Netscape/Explorer Browser Question Additional Email Box CocoNet Account Registration/Retrieval Configuration of Internet Dialer Can't Log On Busy or Slow Connection Email Question Other (describe below)
Program:	-Select one- Microsoft Dialup Networking Microsoft Outlook Express Microsoft Outlook Netscape Internet Explorer Eudora Netscape Mail Netscape News Other (describe below)
Error Message:
Additional Information: