6 Month Extended Contract

Name *

Must match name of current account

First Name

Last Name

Address *

Must match physical address of account

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

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Package Upgrade (select one)

By submitting this form, the customer agrees to pay charges as specified below to 4SIWI on a monthly billing cycle. These prices are for Internet access charges, to include general and unlimited Internet access, such as browsing of the internet, downloading, email, personal website space, and any other internet functionality that pertains to general internet access. These charges do not include services that may be applicable to hosting of servers, additional IP address allocation, or any other form of Internet access that may conflict with services rendered by 4SIWI. In the event that a Customer decides to terminate this agreement the Customer agrees to return all of 4SIWI’s Equipment. If you are still under contract, this will add 6 months to your current two year agreement.

Opal - $39.95/mo. (3Mbps Download x 3Mbps Upload)

Pearl - $49.95/mo. ( 7Mbps Download x 3Mbps Upload)

Garnet - $59.95/mo. (10Mbps Download x 3Mbps Upload)

Ruby - $69.95/mo. (15Mbps Download x 5Mbps Upload)

Diamond - $85/mo. (25Mbps Download x 5Mbps Upload)