Broadband - Internet Registration Form

	Broadband Package Options Please select from the available plan options below
	Broadband Plans Download Limit   CM Lite - 256/64K speed 200Mb * $26.95 /mth 1 Gb $39.95 /mth 5 Gb $44.95 /mth 15Gb $49.95 /mth Unlimited (maybe shaped after 30Gb of Downloads) $54.95 /mth   CM Fast- 512/128K speed 500Mb * $39.95 /mth 5Gb $54.95 /mth 15Gb $59.95 /mth Unlimited (maybe shaped after 30Gb of Downloads) $64.95 /mth   CM Mega - 1.5Mb/256K speed 500Mb * $54.95 /mth 5Gb $64.95 /mth 15Gb $79.95 /mth Unlimited (maybe shaped after 50Gb of Downloads) $89.95 /mth   CM Max- 8MB/384K Broadband2+ 1Gb * $74.95 /mth   15Gb $89.95 /mth 30Gb $99.95 /mth 60Gb $124.95 /mth CM Lite 200MB, CM Fast 500MB, CM Mega 500MB, Plans Excess charged at 9.9c per MB Capped to $79.95 Per Month. CM Max 8MB/384K 1Gb Plan Excess downloads charged at 9.9c per MB Capped to $119.95 Per Month no more to pay. All other plans will be shaped to 64Kbps once Download Allowance is reached. For the CM Max Plans Speeds are shown in downstream/upstream format and speeds are theoretical network maximum speeds. Actual speeds may be less due to a number of factors including network configuration, line quality & length, exchange type, customers premises interference, traffic and equipment. About 70% of customers on the 8MB service can access speeds around 6MB or more. Optional Extras:     0 1 2 3 4 5 6 7 8 9 10 Additional email addresses $0.95 /mth 0 1 2 3 4 5 6 7 8 9 10 Additional Static IP addresses $9.95 /mth Broadband ADSL Installation by Technician onsite (Conditions apply).If more than 60kms from Bunbury, Standard Charges of $99.95 for onsite installation apply. $0.00

	Plan Term / Setup Fee Please select from the available plan term / setup fee options below
	If you have an existing ADSL Broadband connection with another supplier, this fee does not apply. 12 months $99.95 18 months $94.95 24 months $89.95

	DO YOU CURRENTLY HAVE AN ADSL CONNECTION THROUGH ANOTHER PROVIDER?
	No, I currently do not have an ADSL connection   Yes, I currently do have an ADSL connection   Please specify provider:   CM Internet Swap allows customers with an existing ADSL Broadband connection at another Broadband provider to transfer to CM Internet without losing their existing connection and an easy smooth transition to CM Internet. In order for you to be able to swap to CM Internet, your existing broadband provider must also be participating in this process. Churn from my existing provider $30.00

An ADSL Modem is required to use the ADSL connection. CM Internet can optionally provide an ADSL Modem (this is recommended if you do not have an existing ADSL modem.) CM Internet is an authorised Netcomm partner/reseller. Please contact us for any Netcomm hardware not featured on this page.

	ADSL HARDWARE Please select from the available options below
	Netcomm NB2 Modem USB/Ethernet + 1 Phone Line Filter (can only be used with CM Lite 200Mb plan) $89.95 Netcomm NB3 Modem USB/Ethernet + 1 Phone Line Filter $99.95 Netcomm NB4 Modem Ethernet 4-Port + 1 Phone Line Filter $119.95 Netcomm NB5W Modem Ethernet 4Port + Wireless 802.11 + 1 Phone Line Filter $199.95 Netcomm NP7032 PCMCIA Wireless PC Network Card 802.11B (For Notebook-Laptop) $69.95 0 1 2 3 4 5 6 7 8 9 10 ADSL Phone Line Filter $19.95 0 1 2 3 4 5 6 7 8 9 10 10/100 PCI Network Card $29.95 0 1 2 3 4 5 6 7 8 9 10 10/100 PCMCIA Network Card for Notebooks $49.95

	ADSL INSTALLATION ADDRESS AND TELEPHONE
	Address   Town/Suburb State WA NSW QLD VIC ACT SA NT TAS Postcode Please enter the number of the existing telephone service at the above address, to which the ADSL service should be attached. Phone Number

	YOUR COMPUTER
	Does the PC you are connecting the ADSL modem to have a network card? Please select the appropriate option for your computer:   Windows 2000/XP   Windows 98 or ME   Windows NT   Macintosh   Linux or Free BSD   Other

	LOGIN DETAILS
	I have an existing CM Internet Username   Username:   The username forms part of your email address, and must be at least 5 but no more than 16 characters long. Most customers choose a combination of their firstname and surname (e.g. jsmith, smithj, johnsmith) Second Preference Username:   Third Preference Username:         Password:   Confirm Password:   The password must be between 6 - 8 characters long.

	CUSTOMER DETAILS
	First Name Last Name Company Address   Town/Suburb State WA NSW QLD VIC ACT SA NT TAS Postcode Please ensure you enter the area code for any phone numbers supplied. Home Phone Fax Work Phone Mobile Email

	PAYMENT Please select from the available payment options below
	- from your cheque or savings account and payable to CM Internet Cheque/Money Order - payable to CM Internet and post to CM Internet Direct Deposit - deposit your cash, cheque or money order at any Bankwest branch Credit Card - a 2.2% surcharge will be charged for all credit card payments.

	ADDITIONAL INFORMATION
	Where did you hear about CM Internet? Direct Mail   Press / Magazine   Web Site   Friend   During our "refer a friend" promotion, your friend will receive a bonus from CM Internet, if they are an existing CM Internet customer. Please enter their email address below. Friend's email address: I am an existing CM Internet / Computers Mobile customer

	TERMS & CONDITIONS
	I declare that I have read, understood and agree to abide by CM Internet's Terms & Conditions. Click here for a printable version of the terms & conditions. If more than 60kms from Bunbury, Standard Charges of $99.95 for onsite installation apply. You must have Adobe Reader 6 installed. To update or install Adobe Reader click here.