1375 S. Eastwood Dr. Woodstock, Illinois 60098 Phone: 815-338-0549 Fax: 815-338-0567

Registration Form

Please complete the form below to sign up for an internet account.
Stan's Office Machines, Inc. will contact you soon to confirm your registration.
If you have any additional questions or concerns, please email ,info@stans.com.

Please note: Fields in Bold are required.

Personal Information

Name

Organization

Street Address

Address (cont.)

City

Zip Code

Telephone

FAX

E-mail

Computer
Description

Additional connection information

Dial-Up User Name

Dial-Up Password

Confirm Dial-Up Password

Email Name

E-Mail Password

Confirm E-Mail Password

Name
Organization
Street Address
Address (cont.)
City
Zip Code
Telephone
FAX
E-mail
Computer Description
Additional connection information
Dial-Up User Name
Dial-Up Password
Confirm Dial-Up Password
Email Name
E-Mail Password
Confirm E-Mail Password