Application for

Business Internet Services

1. Please tick the appropriate boxes for the services or goods you require:

Leased Line

Bandwidth - Price (Price + VAT)

[ ]	256Kbps - £ 2,000 (£2,350.00) /year
[ ]	512Kbps - £4,000 (£4,700.00) /year
[ ]	1Mbps - £6,500 (£7,637.50) / year
[ ]	2Mbps - £12,600 (£14,805) / year
[ ]	Other (please specify) _______________________

Access to bandwidth requires connectivity solution from premises to MCB Point of Presence.

	Installation	Annual
3.4GHz Wireless (5Mbps)	£2,000.00 (£2,350.00)	£2,000.00 (£2,350.00)
2Mbps Megastream	Call	Call

ADSL

Wires-only

Service contended 50:1 (same as residential)

	ISP Charge (+ VAT)	MT Charge (+ VAT)
[ ]	Up to 2Mbps (best efforts basis) £132 (£155.10) annually	£13 (£15.28) /month

Fixed IP Address

Each service includes one fixed IP address and MT supplied and managed router. Service contended up to 20:1.

	ISP Charge (+ VAT)	MT Charge (+ VAT)
[ ]	Up to 2Mbps (best efforts basis) £408 (£479.40) annually	£40 (£47) /month

Routers

[ ]	Wireless Router/Modem with VPN capabilities

SDSL

Each service includes one fixed IP address and MT supplied and managed router. Service provides a synchronous service (same speed in each direction) contended up to 10:1. A one-off connection charge of £575 (£675.63 with VAT) is applicable. Requires a dedicated phone line (cannot be used for phone calls).

	Service	ISP Charge (+ VAT)	MT Charge (+ VAT)
[ ]	2Mbps	£2,628 (£3,087.90) / year	£90 (£105.75) /month
[ ]	1Mbps	£1,680 (£1,974.00) / year	£75 (£88.13) /month
[ ]	512Kbps	£ 684 (£ 803.70) / year	£60 (£70.50) /month

Miscellaneous

[ ]	SMTP mail forwarding to designated address (free of charge)
[ ]	Anti-virus/Anti-SPAM gateway (£ please call)
[ ]	Five additional POP3 mail addresses - £20/year (£23.50)

3. Please indicate your method of payment:

[ ] Company PO enclosed [ ] Cheque enclosed for £_______________

[ ] Option for user to pay by standing order quarterly (£2 handling charge)

[ ] Please charge to Visa/Mastercard Number: ______________________________

Expiry date: ______________

Signature: ___________________________________

It is understood that you are subscribing to ADSL on an on-going basis for a minimum period of 12 months. Manx Computer Bureau will keep your account open and charge you appropriately until you notify us in writing that you wish to cancel. VAT invoices will be issued annually. The ADSL service is provided, and must be used by subscribers, in accordance with the Isle of Man communications legislation. All users are advised to familiarize themselves with such legislation and Manx Computer Bureau reserves the right to withdraw service in the event that a subscriber is proved to be in breach of Manx law.

3. Your full name:(Mr/Mrs/Miss)_______________________________________

Company: _________________________________________________________

4. Address:    _________________________________________________________

_____________________________________________________________________

5. Telephone: ________________________ (home/office)

Fax: _______________________

6. Signed:       ______________________________

Date: _________________________

7. Your Internet address will be of the form [host].mcb.net. Also choose login and password (at least 6 characters, mixed case, digits and punctuation recommended) for ADSL access. If you need advice or require multiple POP3 mailboxes, contact Support at the address below.

Write your preferences here:

[host] _____________________ [login] ____________@mcbnet-[512,1mb,2mb]

Password ________________________

Return completed application form to:

Manx Computer Bureau Ltd, M & G House, Head Road, Douglas IM1 5BF.

Tel: 01624 623841. Fax: 01624 623004. Email:admin@mcb.net

Account No:

Company Name:

(for office use only)