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Return to WVNET Education Rebate Program

Sign Up Online for a
WVNET Internet Account

This form will send your information to the WVNET Help Desk and they will contact you by phone with your user name and password. After submitting this form you will need to send in your billng information. (You will be directed to the forms for Credit Card and Automatic Debit** Payment after submitting this form.)

** To pay with automatic debit, the first payment must be made with a check. Check and payment form must be received within first week of signing up.

WVNET Education Rebate Program
*Last Name
*First Name
School Affiliated with:
Send Rebate To this School:
*Email Address
 Please indicate the email address you use most often.
Address:
City
State
Zip
Phone
Fax
Questions/Comments:
* denotes mandatory field

This form will send your information to the WVNET Help Desk and they will contact you by phone with your user name and password.