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ADSL Internet Order Form  (please print, complete, sign and fax or post to us)

Date:   ________________________
Company: ________________________
First Name: ________________________
Last Name:  ________________________
Address:  ________________________
Suburb:  ________________________
State:  ________________________
Postcode:  ________________________
Contact Phone: ________________________
Contact Email: ________________________
I am 18 Years of age or older:   Yes  O No  O
I have read and agree to the Visp Internet Terms & Conditions: Yes  O No  O
Click here to view Terms & Conditions
Starter Plans Monthly Fee  Activation Fee  
256k/64k - 500MB  $        39.95  $         149.00 O
512k/128k - 500MB  $        54.95  $         149.00 O
1500k/256k - 500MB  $        84.95  $         149.00 O
     
Usage Based Plans Monthly Fee  Activation Fee
256k/64k - 1GB  $        49.95  $         149.00 O
512k/128k - 1.5GB  $        69.95  $         149.00 O
1500k/256k - 2GB  $       119.95  $         149.00 O
Flat Rate Plans Monthly Fee  Activation Fee
256k/64k - 5GB  $        59.95  $         149.00 O
256k/64k - 20GB  $        69.00  $         149.00 O
256k/64k - 30GB  $        79.95  $         149.00 O
512k/128k - 15GB  $        84.95  $         149.00 O
512k/128k - 30GB  $        99.00  $         149.00 O
512k/128k - 50GB  $       109.95  $         149.00 O
1500k/256k - 25GB  $       149.95  $         149.00 O
1500k/256k - 50GB  $       199.00  $         149.00 O
1500k/256k - 60GB  $       209.95  $         149.00 O
Other Charges & Conditions
▪ Activation fee for New Account $149.00
▪ Static IP $10.00 per month
▪ Excess Data on Usage Plans Charged at 10cents per Mb
▪ Account Keeping Fee if Required $5.00
▪ Onsite installation by a VISP Internet technician is available for $88 per hour + materials
▪ Fee for Incorrect Callout $88.00
▪ Change to Account Type $66.00
▪ Disconnection Fee $88.00
▪ Change to DSL Service (eg IP Address Pool) $66.00
▪ Telstra fee to carry out Service Qualification of Pool $110.00
▪ Telstra/Comindico Fee incurred by Customer Direct Call $150.00
▪ An initial 6 month minimum contract applies to these services.
▪ Account customers will receive a tax invoice in advance, and MUST be paid in advance.
▪ Monthly payments MUST be paid in advance. 
▪ These services can also be invoiced on a quarterly basis, paid in advance. 
▪ ADSL services are non-refundable. 
▪ 5 Free email addresses are included with every VISP Internet ADSL account. 
HARDWARE
Billion ADSL Ethernet/USB Router $137.50
Line filter Austel approved $30.00
higher level equipment available on request
ADSL Phone Number: ________________________
(phone number nominated for ADSL)
User Name: ________________________
(lowercase 2-8 characters)
Password:  ________________________
(numbers and/or letters 6-8 characters)
Preferred Email Addresses: _______________@visp.com.au
(up to 5 for free) _______________@visp.com.au
_______________@visp.com.au
_______________@visp.com.au
_______________@visp.com.au
My preferred payment method is:  
Credit Card 
Card Number:   ________________________
Credit Card Type:  ________________________
Expiry Date: ________________________
Card Holder:     ________________________
Direct Deposit 
Adelaide Bank BSB 610-101 Acct 070659732
Signed:  ________________________
(remittance must be received prior to account activation)

 

 
 
  If you require any assistance, please email us at  accounts@visp.com.au
   
   


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