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Midwestern Applied Climate System (MACS)
Subscription Form

Instructions: Fill out the form below, print it and fax it to the Midwestern Regional Climate Center with Visa, Mastercard, Discover or American Express number along with security code, expiration date, the card's billing address zip code, and name as it appears on the card. Or, you can mail this form with check payable to "University of Illinois/ISWS Dept. M". You can print this form by clicking on "Print This Form" below.

Click here for details about MACS subscription types and policies.

Name:
Company:
Address:
City: State: ZIP:
Telephone: Fax:
Contact Person:
E-mail:
User Log-on Identifier (user name):
First Choice:
Second Choice:
Password (at least 6 alpha-numeric characters, avoid "real" words like "climate"):
First Choice:
Second Choice:
Account Type:
Standard Account
Value Plus Account
Credit Card Information:
(Credit card information is not being sent over the internet, so there is no danger
of your information being intercepted.)

Type:

Amex    Discover    MasterCard    Visa

Security code: (three-digits found on the back of Discover, MC and Visa cards;
four-digits found on the front of American Express cards)
Number: - - -
Expiration date:
Zip Code: (of Credit Card billing address)
Name as it appears on the card:

Print This Form

Fax to: 217-244-0220

Or, mail with check payable to "University of Illinois/ISWS, Dept. M" to:
Midwestern Regional Climate Center
Illinois State Water Survey
2204 Griffith Drive
Champaign, IL 61820-7495

For more information, call the Midwestern Regional Climate Center at: 217-244-8226
Or e-mail us at: mrcc@isws.illinois.edu


Midwestern Regional Climate Center
Last Modified 05/07/2008



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