Dialup Plans
| Title _______ Name: ________________________ Surname: __________________________ | |
| Business Name: _______________________________________________________________ | |
| Address: _____________________________________________________________________ | |
| City/Town: _______________________ Post Code: _________ Phone: __________________ | |
| (2-8 Characters, a-z, 0-9) e.g. username@westserv.net.au Username: 1st preference _____________________ 2nd preference _____________________ |
|
| Date:______________ |
NOTE: All prices are GST inclusive
Please indicate
the usage option required with a cross. 
|
|
Account establishment fee: $11.00 |
|
Connection fee: $44.00 (Optional) |
|
|
Lite - $9.90 per month or $25.00 per quarter. 70MB max download, 20 minute idle timeout, 6 hour max call duration. Excess charges apply, Excess charges capped at $20.00 per month and charged monthly. CREDIT CARD ONLY |
|
|
Mega - $24.90 per month or $66.00 per quarter. 20 minute idle timeout, 6 hour max call duration. |
All listed plans come with 1 email address as standard.
5MB of personal webspace is also available at no extra charge upon request.
Multiple simultaneous connections are NOT permitted.
(Above prices are subject to change without notice. Confirmation on application acceptance.)
Note: No long term contract is required for any of these plans.
All access is to be pre-paid. Data used in excess of that specified
by the plan will be charged at 18 cents per MB in arrears.
| Email: accounts@westserv.net.au | Forbes: 1300 664 694 | Fax: 02 6851 4400 |
Total up front Payment: $ _____________ I wish to pay: Monthly/Quarterly (Please Circle your preference)
| Bankcard
|
Mastercard
|
Visa
|
Card Number: _________ _________ _________ _________ Expiry Date: ______/______
Name on Card: ____________________________ Signature: ______________________________
I have read the "Conditions of Use - Western Internet Services" and agree to the terms and conditions therein.
Signature: ______________________________ Date: ______/______/______