BKB Internet - Internet the way it should be!
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Simple ADSL2+ Application Form
Step 1 of 2
50%
Your Details
Please provide the current details for existing telephone service on which you want ADSL2+ Connected.
Name
First
Last
Address
Street Address
Address Line 2
City
State / Province / Region
Zip / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Northern Mariana Islands
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
ADSL Residence Number
Connection Details
Connection Option
12 Month Contract - BYO Modem - $99
24 Month Contract including Basic Modem - $0
Simple ADSL2+ Plans
Services that download more than the Included Use Amount will be shaped to 128/128kbps
Rate Plans
Standard Rate
Preferred Rate
Preferred Rate offers you a discount on your monthly fee for choosing to pay via automatic payment and to accept your invoices electronicaly.
BKB Preferred Rate Conditions
Customer must pay by Visa / MasterCard on Automatic Payment
Customer must accept electronic invoicing (PDF invoices email to their nominated email address)
Plans
Standard ADSL2+ Shaped 10GB - $65.00
Standard ADSL2+ Shaped 25GB - $70.00
Standard ADSL2+ Shaped 50GB - $85.00
Standard ADSL2+ Shaped 100GB - $110.00
Standard ADSL2+ Shaped 150GB - $135.00
Standard ADSL2+ Shaped 200GB - $160.00
Plans
Preferred ADSL2+ Shaped 10GB - $55.00
Preferred ADSL2+ Shaped 25GB - $60.00
Preferred ADSL2+ Shaped 50GB - $75.00
Preferred ADSL2+ Shaped 100GB - $100.00
Preferred ADSL2+ Shaped 150GB - $125.00
Preferred ADSL2+ Shaped 200GB - $150.00
Email Address
Up to 5 email addresses (@bkb.net.au) are included with your service.
1
3
3
4
5
Service Authentication
Please provide a password for your service to use to connect.
Password
*
Agreement
I the undersigned have read and accept the BKB Internet ADSL2+ Broadband Supply Agreement, Terms and Conditions, Acceptable Use Policy and Spam Policy (located at http://www.bkb.net.au/).
I have read and understood the information about BKB Internet’s handling of information about me (personal information).
I give BKB Internet consent to obtain and use credit information about me, including information about my credit history.
I understand that once an application is made it cannot be terminated without paying a cancellation / termination fee.
I agree that by signing of this form, BKB Internet Pty Ltd is under no obligation to accept my application until they are satisfied that all of the information I have provided is true and correct.
I acknowledge that this service has been designed as a residential product. While all effort has been made to make the experience as enjoyable as possible, the service does not offer the QoS or SLA guarantees that Business Grade services offer.
Finally I agree to pay BKB Internet Pty Ltd the fees above as a part of this application and understand that a full refund will be made if this application is rejected.
Acceptance of Agreement
*
I agree to and accept all terms of the above agreement
Do you have any questions that I can help you with?
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