Order Information
 
Order Type:
Promotion:
 
 Personal Information
 
First Name: *
Last Name: *
Company:
Account Number: * *
Phone No For ADSL: *
Contact No: *
Mobile Number:
Email Address:
   
* Your 12 digit Account Number may be found in the top left corner of your bill.
   
 Plan Details
 
Setup charges apply to new services and downgrades. Downgrade fee is $60 and may be waived if signing a new year term commitment. Below charges do not include a telephone line, which must be ordered separately. A $60 fee will be incurred when moving existing ADSL service.
ADSL Plan: *
   
 Getting Connected Details
 
Getting Connected:
   
 Modem Details
 
ADSL Modem: *
LIME reserves the right to substitute modem of equal or better quality for the same price.
 
No Of Microfilters: *
 
LIME provides 3 Microfilters per line. No filter is required on the computer line. Additional Microfilters are available from at a cost of $3.50 each.
   
 Delivery Details
 
Modem and starter pack, if ordered will be delivered during regular business hours.
Delivery Option: *
Daytime Delivery Address:
   
 Username Deatils
 
Usernames should not be more than 12 characters and should not include any symbols, special characters, or spaces. Use an underscore ( _ ) if you want to leave a space. The username is for both ADSL Internet Access and your personal web page, e.g. http://www.candw.ky/users/username.
Username: *
Password: *
   
 Email Address Details
 
E-mail addresses should be no more than 32 characters and should not include any symbols, characters, or spaces. Use an underscore ( _ ) if you want to leave a space. If your chosen e-mail address is not available, a similar e-mail address will be assigned. Additional e-mail addresses are available at an additional charge.
Email:
Password:
Email:
Password:
Email:
Password:
Email:
Password:
Email:
Password:
Email:
Password:
Email:
Password:
Email:
Password:
Email:
Password:
Email:
Password:
   
 Webspace Details
 
Webspace can be activated at a later date by sending an email to netsales@candw.ky
Activate Webspace:
 
   
 Additional Information
 
CW Sales Person:
Comments:
 
   
 Declaration
 
I declare that the information on this Order Form is true and accurate. This Order Form incorporates by reference the Terms and Conditions contained in items 100, 101, 200 and 201 in the Cable & Wireless Special Tariff available upon request at www.candw.ky, and by which I agree to be bound. I understand that Cable & Wireless will not be providing firewall protection and I accept responsibility for my own security. I understand that the contract for service is for a term period selected and I accept that a fee as outlined in the tariffs, will be charged for early cancellations. This Order Form is accepted by LIME on the earlier date of notice by LIME of Order Acceptance or the Service Start Date.
   
Date: 4/2/2012  
   
All fields marked with an asterix are mandatory and must be completed for the order to be submitted. If the order is submitted sucessfully, a confirmation page will appear with your order confirmation number.