Sneaker Net

APPLICANT DETAILS

    Name:    ______________________________________________________________

    Address: ______________________________________________________________

    Ph Home: _______________  Work: _______________  Other: _______________

    Fax No.: _______________  EMail Address: ______________________________

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SERVICE REQUIRED

Account Required
          ___ Personal     ___ Business     ___ Company     ___ Dedicated
Account Name (Please fill in 3 options for the account name in order of preference - Min. of 3 Chars - Max.8)
  Opt 1:____________  Opt 2:____________  Opt 3:____________  Password:___________
Additional Mailboxes (Please fill in 3 options for the account name. Min.3 Chars - Max.8)
  Opt 1:____________  Opt 2:____________  Opt 3:____________  Password:___________

  Opt 1:____________  Opt 2:____________  Opt 3:____________  Password:___________
If you require more mailboxes please copy this sheet as required.
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How did you find out about Sneaker Net?
   ___ A friend   ___ Print Advertising   ___ Internet   Source Name:______________  
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SERVICE AGREEMENT
I have read, understand & agree to the terms indicated in the Account Terms Document on this site in the following location: 'http://www.sneaker.net.au/docs/terms.htm'. Signed: _____________________ per account applicant.
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Please allow around 2-3 days for new dial-up accounts to be configured. Dedicated accounts require a unique line and modem to be set-up and may take several days depending on phone line connection. Once the requested service is active, a Sneaker Net representative will contact you with the information you require to get you started.
Note: Account will not be activated until initial payments are recieved, so ensure initial payment is sent with application.
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