O r e g o n ' s   I n t e r n e t   S e r v i c e   P r o v i d e r
Hevanet
Secure Form

 Hevanet Gift Subscription Form 

Print this form and mail (or FAX) to:
Hevanet Communications - PO Box 91124 Portland, Oregon 97291

or click the SUBMIT button below.
Give a friend a Hevanet subscription for any occasion. Simply fill in the information below. You can choose to have the account information sent to either you or your friend.
Person's Name: Preferred Email Address:
(8 characters or less)
Address: Operating System:
City/State/Zip Phone Number:
Subscription Start Date:
Your Name: Type of Payment:
Email address: Expiration Date:
Card Number:        Phone Number: 
Address: Fax Number: 
City/State/Zip Send Account 
Information to:
Comments or Notes
Amount: 
Send future Invoices to:
  
_______________________________
_______________________________
Signature
Date
 
 
© Copyright 2008
Hevanet Communications
All Rights Reserved.