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Application Form

Complete your details to open an Internet Access Account

This requires a forms capable browser. If your browser cannot handle forms then use this page.

Your details

Name:
Current email:
Telephone:
Address:

Internet access account details

You will be allocated an internet address of the form userid@hostname.u-net.com
Please give your choice of userid and hostname:

Userid: 2 - 8 lower case characters - your "handle"

Hostname: 2 - 15 lower case characters - your computer's "handle"

1st choice 2nd choice

Password: 6 - 8 lower case letters

The software and installer is usually posted out on disks or CDROM. If you have an existing Internet connection with the means to transfer downloaded files to your Amiga, you may opt to download the software instead.

If you have bought the NetConnect software pack you should use that instead of the Wirenet software.

Please select one of the following options:: Software on disks; Software on CD; Download software; Use NetConnect

Once you have sent this form, post your cheque/PO for either £129 or £28.25, together with the a completed Standing Order Mandate for monthly payments, to:

Wirenet Amiga Internet

39 Larch Avenue

Penketh

Warrington

WA5 2AZ

Your startup pack will be mailed out within two working days of receiving your payment.

Standing Order Mandate

To the Manager  ....................................................   bank
Address         ....................................................
                ....................................................

Sort code:      ..............    Account number: ..................

Account name:   ....................................................

Please pay the sum of �14.25 into the account below on the 1st/15th*
of each month, beginning with the month of ...........


Sort code:      20-91-48    Account number:   70162094
Account name:   Wirenet

Signature:  ..................................
Date:       ..................................
Telephone:  ..................................

* The standing order must be paid on the date soonest before the renewal is due. i.e if you subscribe before the 15th, then select the 1st. If you subscribe after the 15th, select the 15th. Your subscription renewal date remains on monthly intervals from the date the account is opened.

This page was last updated on Thursday 18 Jun 1998.