Title ...... First name ............. Last name .........................
Address ............................................................
............................................................
Town ............................................................
County ............................................................
Postcode ....................................................
If under 18, please give date of birth .... / .... / ....
Phone ........................ Fax ........................
Existing email address (if any) ...................................
Please tick boxes to receive promotional material by post[ ]and/or by email[ ]The CamNet online directory is similar to a telephone directory that all users can search.
Can we include contact details in the
CamNet online directory? Yes [ ] No [ ]
Primary use of account Private [ ] Organisation [ ]If the account shall primarily be used on behalf of a business, charity or organisation please fill in the following:
Name of organisation .................................................. Position in organisation ..................................................
Type (eg IBM PC) ..................... Model (eg 486) ................ System software (eg DOS/Windows 3.1) ......................................
Payment method (please tick one) Cheque [ ] Access [ ] Visa [ ] Card number .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. If paying by credit card please ensure the address is the same as that to which your statements are sent. Expiry date .... / .... (Cheques payable to: CamNet)Declaration: I declare that all the above is correct and that I have read the CamNet terms and conditions (Reg 002).
Signature ...................................... Date .... / .... / .... If under 18, then parent or guardian should sign above on applicant's behalf and also supply their full name in the space below. ............................................................................Return your completed form to Camnet, PO Box 321, Cambridge CB1 2TF. Credit card orders can be faxed to 01223 500601.
A letter explaining how to connect and get started will be dispatched
within 14 days of receipt.
NB For the purposes of this document, CamNet is a trading name of
Cambridge Freenet Ltd.
