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Dial Up Internet - Application Form

Fill in this form online then print it out and fax it to (02) 9613 0507
or mail it to PO Box 4162, Parramatta NSW 2150.
Personal details

First name:

Surname:

Street:

Suburb:

Postcode:

Home Phone:

Work Phone:

Mobile Phone:

Account Details

User Name

This will be your login name and email address, eg user@depot.com.au.

- 1st Choice:

- 2nd Choice:

Password:


Please refer to "Choosing a Password - Your Rights and Responsibilities"

Dialup Plans

Click here for more info about Dialup Plans

Unlimited

$27.50 per month, 3 hour session time limit

Unlimited w/ Credit Card

$25.00 per month, 3 hour session time limit

Casual-50

$20.00 for 50 hours, $1.00 per extra hour up to a maximum monthly spend of $30.00

Casual-20

$12.50 for 20 hours, $1.00 per extra hour up to a maximum monthly spend of $30.00

Casual-2

$2.00 for 2 hours, $1.00 per extra hour up to a maximum monthly spend of $30.00

Connection Methods

Click here for more info about Connection Methods

Set-Up CD, mailed to you

In Home Set-Up, FREE in the Parramatta area

Over the phone, you must already have an internet browser and email editor installed

Preferred Payment Method

Cheque or Money Order

Direct Deposit

Technocash

American Express

Diners Club

Bankcard

MasterCard

Visa

Cardholder Name

Card Number

Security Code

Expiry

By entering your credit card details here you are giving Depot IT permission to use this card for payments for Internet Access. Please refer to our Terms and Conditions.

Other Information

How did you find out about us?

Flyer Poster Newspaper Referred by friend/associate
Other. Please specify

What operating system do you use?

Windows 3.x Windows 95/98 Windows NT/2000
Other. Please specify

Do you have a modem?

Yes No

 

Please read the Terms and Conditions of use before printing and sending this form.