Print this Form and Fax to Enter.Net at (610) 435-3550 Revised 1/31/2000

Form processing generally takes 24 hours

ROAMING PAYMENT AUTHORIZATION

Service: The roaming software service is billed from the first of the month to the end of the month. You must have a valid, up-to-date credit card number on file with Enter.Net to use the service. Additional costs vary per hour depending on the location that you are dialing from. These additional charges will be charged to your account at the end of every month. YOU are ultimately responsible for any access number you use while roaming.

I/We authorize Enter.Net to charge my/our credit card account for any and all charges that occur using the IPASS ROAMING SOFTWARE. I/We understand that there will be no refunds for any reason and that I/We are responsible for all charges incurred from my account and that you may suspend iPass priveleges at any time.

Credit Card Type (circle one): VISA  Mastercard  Discover  American Express

Credit Card Number: _______________________________

Exp Date: _________

Signature:_________________________________

Print Name:________________________________

Username:_________________________

Password:_________________________

Today's Date:________________

Address:___________________________________

___________________________________________

Phone:_____________________________________