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One Internet with Equal Access for All
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Bobby Approved (v 3.2)
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Copyright ©2000-2002
Online Policy Group, Inc.

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Request Shell Account

Please fill out this form to request creation of a new shell account.

First Name:
Middle Name:
Family Name:
Email:
Phone (primary):
Phone (backup):
Street Address:
City/Town:
State/Province:
Postal/Zip Code:

Pick one:
Organizational Use
Individual Use
Organization name (skip if for "Individual Use"):
Description of organizational or individual activities (brief):
Annual Budget:

Shell Account Username Requested:
Shell Account Password Requested:

Are you 13 years of age or older? (required by COPPA law in the United States)
Yes, I am 13 years old or older
No, I am under 13 years of age

The Online Policy Group (OPG) will not share the information you have provided without your permission:
OPG may share my information with other organizations (provides you with other interesting opportunities and helps OPG to exchange lists in order to do outreach and fundraising).
OPG may share my information only within OPG.
OPG may not share or store my information except for administration of the services I have requested.

I agree to be listed as a client of the Online Policy Group on the OPG website, brochures, and grant proposals.

Note: You will be added to an administrator email list to keep you informed of service changes.

I have read and agree to the Terms of Service policy of the Online Policy Group, Inc.

Click here to submit your report (click only once!):


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