Indiana University Account Online Signup Form

To request a dialup account, please fill out the form below completely and press send. All fields are required for the prompt processing of your account. Each I.U. faculty member, staff member, or student is eligible for only one account at discounted rates listed below. Additional accounts are available at IQuest's regular published rates. IQuest cannot guarantee the availability of any requested username. Approximately 24 hours after you submit your application, you will be contacted by IQuest support with your setup instructions and password. For technical assistance, contact IQuest Customer Service at 1-866-896-4056.

User Information

Current Email Address:
(For verification purposes, you must use your IUPUI email address, e.g. "jdoe@iupui.edu")

Full name:

Date of Birth: (mm/dd/yy)
(Used for verification purposes)

Home Phone:

Address:

City:

State: Zip:

Driver's License Number: State:
(Used for verification purposes)

Requested Login ID: 2nd Choice ID:
(3 to 12 characters, cannot end in the numeral "1" and cannot have spaces or periods)

Additional Email addresses: ( allowed up to 6 additional )

Billing Method: (Check One)

Credit Card
Quarterly paper billed

Account Type:

$12 – Local 33.6/56k/ISDN modem
$16.95 – IQuest Xtreme - Accelerated + National Dialup 33.6/56k/ISDN modem
$24.95 - DSL w/ 1yr contract
$34.95 - DSL

Operating System:

Windows 98
Windows 2000
Windows XP
Macintosh (OS 8.x or higher)