Island Computers/Newtel Broadband application


Your Location

Please confirm the location where the Broadband line is to be installed and the type of service you require

Location:  

  Service:  

If you are an existing Guernsey.net or Localdial customer please tick

If you currently have a dial-up Internet Access account with Guernsey.Net or Localdial and would like to cancel it
once you have broadband please tick

Customer Details
Title
First Name(s)
Surname
Company Name (if applicable)
Customer Address
This is the name and address of the person who Newtel will bill for this service


Postcode  
Day Contact Telephone
E-Mail

Service Details
My installation address is the same as the address i have given above.  
Installation Address


Postcode  
Telephone Number
This is the telephone number of the line that the Xband service will be installed on.
The line must be a Jersey Telecom/Cable & Wireless analogue telephone line fitted with a Jersey Telecom/Cable & Wireless approved master socket
Number of telephone sockets connected to the above telephone number This will determine the number of additional line filters required (see terms of service 1.5 for an explanation of line filters)
Jersey Telecom/C&W Billing Name
Jersey Telecom/C&W Billing Address



This is the name and address of the person billed by Jersey Telecom/Cable & Wireless for the telephone line on which Newtel is to install the XBand service.


Postcode  

Installation Options and Installation Charges
Please select your preferred option.
1a. Connection only £0.00
2a. Connection, fixed modem, two line filters, self-installation £30.00
2b. Connection, wireless modem, two line filters, self-installation £45.00
3a. Connection, fixed modem, two line filters, Island Computers engineer installation £80.00
3b. Connection, wireless modem, two line filters, Island Computers engineer installation £95.00
£ 
Number of additional line filters required  @ £4 each
One line filter is required for each telephone socket connected to the
telephone line used by XBand (Two line filters are provided with options 2 and 3)		 £ 
TOTAL £ 

Recurrent Service Charge
Please tick one payment option only Monthly    
Broadband (2048K-256K ) £21.99
Broadband (2048K - 256K ) + Broadband Talk £24.98

This recurrent charge will be billed monthly. Direct Debit forms are available from Newtel. Existing Guernsey.Net and localdial customers will continue to pay by credit card, Standing Order or on receipt of an invoice.

Other Options
None     Monthly    
1 Fixed IP £15.00


Fixed IP addresses are required for connecting to web servers and mail servers etc. They are not required for general web usage.
Credit/Debit Card details

Customer Declaration
Please tick the operating system used by your computer (*indicates the Newtel supplied modem requires a free Ethernet port)
*WINDOWS 98/ME   *MAC OS X   *Mac OS/9   *Windows 2000   *Windows XP   *Windows VISA   *Linux  
I am/We are 18 years of age or over and make this application having understood all applicable Terms & Conditions and Service Charges concerning this Contract.
I/We understand that I/We will be responsible for all charges as applicable for a Minimum Contract Period of Twelve Months.
I/We agree to the terms set out above and confirm that the details I/We given are accurate.  
Reseller Identification Number   040 - Island Computers, Alderney (Reseller Use ONLY)