Broadband ADSL Change Request Form
Please complete the following form. All items marked with a red arrow are mandatory.

Order Information
Order Type:Change Service
Promotion:
 
Personal Information
First Name:
Last Name:
Company:
Account Number: *
Phone No For ADSL:
Contact No:
Mobile Number:
Email Address:
   
*Your 8 digit Cable & Wireless Account Number may be found in the top left corner of your Cable & Wireless bill. Click here to see an interactive sample 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.

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Plan
Speed
Email
IP Address
Web Space
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Mega 1024/512 5 1 dynamic 3 MB
Mega NC 1024/512 5 1 dynamic 3 MB
Mega Plus 2048/512 10 1 dynamic 5 MB
Mega Plus NC 2048/512 10 1 dynamic 5 MB
Mega Max 3072/512 10 1 dynamic 5 MB
Mega Max NC 3072/512 10 1 dymanic 5 MB
Mega Extreme 4096/512 10 1 dynamic 5 MB
Mega Extreme NC 4096/512 10 1 dynamic 5 MB
Premier 3072/512 5 1 static 5 MB
Premier Plus 4096/1024 10 1 static 5 MB
Premier Max 6144/1024 15 1 static 5 MB
Mega Optimum / MB
Mega Optimum NC / MB
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Plan
Setup
1 Year
2 Year
3 Year
Monthly
Monthly
Monthly
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Mega $60 $40* - -
Mega NC $60 $50* - -
Mega Plus $60 $59* - -
Mega Plus NC $60 $69* - -
Mega Max $60 $74* - -
Mega Max NC $60 $84* - -
Mega Extreme $60 $99* - -
Mega Extreme NC $60 $109* - -
Premier $60 $114* $102.60* $91.20*
Premier Plus $60 $139* $125.10* $111.20*
Premier Max $60 $199* $179.10* $159.20*
Mega Optimum $60 $119* - -
Mega Optimum NC $0 $129* - -
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ADSL Plan:
   
Modem Details
ADSL Modem:
Cable & Wireless reserves the right to substitute modem of equal or better quality for the same price.
   
Username Details
Please enter your existing Cable & Wireless Username. Usernames cannot be changed.
Username:
  
   
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 Cable & Wireless on the earlier date of notice by Cable & Wireless of Order Acceptance or the Service Start Date.
   
Date: 4/2/2012  
   
All fields marked with a red arrow above 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.