ISDN & Dialup Application

This is not the secure signin page. You can click here for the secure signin page.


Once you have decided on the plan you would like (see Dial up or ISDN ) please either call us for setup over the phone on (08) 62679130 (National 1300 365 678) or complete the following service request form. Please note the following:

  1. When calculating usage 1 Gb = 1000 Mb.
  2. Additional data in excess of your nominated amount is charged at the applicable rate for your plan, (see Dial up or ISDN )
  3. Your account will be operational within an hour or two.
  4. You must accept the terms and conditions at the bottom of this agreement by ensuring you place a tick in the box. The application can not be processed with out this.

Terms are strictly payment in advance. Payments must be made prior to the 1st of each month.
Payment for the setup fee and first month must be supplied with this request form in order for us to accept and process it.

Your name*

 Company Name (If Applicable)

Your e-mail address*

 Do you require a Modem*
Do you require cable work done on site (phone point or network cable relocation or installation?
Yes or No
User Name Required* Password Required* (4 or more numbers, characters, letters)
Address* Suburb*
Post Code* Work Phone Number
Home Phone Number* Mobile Phone Number
 
What type of connection would you like
What Plan would you like to join*
Do you require Spam, Virus and Offensive Content filtering
Speed Required*
Data Amount Required (unlimited or amount required)*
 Gig
 
Where do you wish to access the Internet from
Perth Metro
Regional
 (This option for Aust Wide Roaming)
 
Payment Method
Cheque, Cash or Money Order
EFT (Electronic Funds Transfer)

Please make payable to West Australian Networks and post to:
PO Box 532 HILLARYS WA 6923 or
drop it into any branch of the National Australia Bank . You will need the bank details on the right
  • Account Name: The Emery Corporation P/L T/AS West Australian Networks
  • BSB Number: 086495 Account Number: 691499751
  • Please ensure you mark the deposit with your name for ID at our end.
 
Credit Card
Visa
MasterCard
Amex*
Diners
 
Credit Card Number
Expiry Date
Name On Card
*AMEX Security number
 For Amex cards you need the 4 digit ID code found on the right had side just above the card number.
By completing and submitting this form I authorise West Australian Networks to debit my nominated credit card (above) for any valid charges incurred by the use of this service.

Your comments

Please reply to my comments

  

I hereby certify that I am authorised to sign the contract and instruct WA Networks to provide the service requested.

I have read, understand & agree to be bound by the Terms & conditions of this application including the Acceptable Use Policy (AUP)*
 

NOTE: If you receive an error message reading: "The form was not submitted for the following reasons: You are coming from an unauthorized domain. Please use your browser's back button to return to the form and try again".

This problem is caused by your personal firewall blocking HTTP referrer information (cookies) which the script checks as a security measure. When that information is blocked by your firewall software, the form returns the error message you received.

To send the form, you can temporarily disable your firewall (which you should be able to do by right-clicking its icon in the system tray* and selecting the option to disable it), and then try submitting the form again. Once you submit the form, go back to the system tray icon and right-click again to turn the firewall back on.

We are sorry for the inconvenience, but in this age of hackers, spammers, and worms, we are trying to protect our site from abuse.

IF YOU STILL HAVE PROBLEMS, Please email us cag@westnet.net.au