COMPUTER CENTRAL BILLING AUTHORIZATION
1014 Third Avenue New Brighton, Pa.
15066 Voice (724)-846-3063 Fax (724)-846-0423
8 East Washington St. New Castle, Pa. 16101 Voice (724)-658-8744 Fax (724)-846-0423
1. Wireless
Applicant Information
ADDRESS:
__________________________________________________________
WORK PHONE______________ HOME PHONE _________ FAX_____________
2. Bandwidth
Type and Speed
I hereby request Computer Central to subscribe me to the bandwidth type
and speed I have chosen.
Select your maximum, burstable speed below Please check one
_____128k Bandwidth Residential $20.00 $40.00
_____256k Bandwidth Symmetrical $30.00
$60.00
_____384k Bandwidth Symmetrical $40.00
$80.00
_____512k Bandwidth Symmetrical $50.00
$100.00
_____640k Bandwidth Symmetrical
$75.00 $150.00
_____768k Bandwidth Symmetrical $100.00
$200.00
_____ Custom Speed
__________ __________ __________
3. Internet
Tech Support for Software
If you currently have Internet software, contact Your Local CCIA.NET
Retailer to ensure that it's compatible with our system. If you do not have Internet software and you
will be purchasing Internet software, we supply technical support for the following
packages.
Netscape 6.2 All Versions and
lower/ Microsoft Explorer 6.0 and lower
NO support is
provided for the following items:
A. Hardware or Operating System problems in Windows,
and Unix, that are not
directly
related to the configuration of the Internet Software.
B. Internet Phone, Relay Chat, Video Conferencing,
Gaming or Messaging Software.
4. PAYMENT TERMS
CCIA.NET will bill your account using the terms
below. If you are signing up in the
middle of the month we will pro-rate the remainder of the month. You must pay for at least one month of service,
plus any additional days. For
those paying by check, cash, or money order, on approximately the fifteenth day
of your billing cycle, CCIA.NET will send e-mail to your account stating that payment is due by the first of
the next month in order to keep your account active. If you choose to pay by
credit card, your account will continue to be charged every billing cycle until
you cancel your account in writing with your signature.
I authorize Computer Central to accept the
method of payment that I have chosen.
circle one -> CASH *
CHECK * MONEY ORDER
PLEASE CHOOSE THE FOLLOWING PAYMENT TERMS
_____ MONTHLY
(Pay in one month increments, with $30.00 setup fee)
* * * * * * * * * * * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
circle one -> VISA * MASTER CARD *
DISCOVER * AMERICAN EXP
CARD
#_____________________________________________EXP DATE__________
CARDHOLDER'S NAME
_____________________________________
Please charge the above credit card in the amount
of $__________ in order to activate
my subscription. Computer Central will
bill my credit card $________ monthly.
PLEASE CHOOSE THE FOLLOWING PAYMENT TERMS.
_____ MONTHLY
(Pay in one month increments, with $30.00 setup fee)
* * * * * * * * * * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
5. Applicant
Signature
SIGNATURE
_______________________ DATE __________
By signing this form, the applicant gives Computer Central the permission to bill using the payment terms they have chosen for internet connectivity. Billing will continue without exception as stated in the attached billing policy until cancellation is received in writing with a signature by Computer Central prior to the next billing period.
COMPUTER CENTRAL
1014 Third Avenue New Brighton, Pa.
15066 Voice (724)-846-3063 Fax (724)-846-0423
8 East Washington St. New Castle, Pa. 16101 Voice (724)-658-8744 Fax (724)-846-0423
COMPUTER CENTRAL BILLING
POLICY
We at Computer Central realize the growing number of
Internet users. Due to this we have
devised this policy that will cover all of the billing aspects. We bill on a thirty day basis without
exception. Upon signing this agreement,
you will be automatically charged for one full month even if you cancel the
next day and you will be refunded for the remaining month(s) minus any setup
and or cancellation fees. Refunds take
2 to 4 weeks to process.
We bill
via e-mail every month. If you chose a
credit card for your method of payment you will not receive this e-mail but
will notice the charge on your invoice for the month that it comes due. You will receive an e-mail from the
accounting department fifteen days before your bill will come due on the first
of the month. You will then have a five
day grace period in which to pay your account.
At the end of the fifth day, if your account has not been paid it will automatically
be suspended. If your account gets
suspended due to lack of payment or for an action of your own doing, you will
still pay the full amount regardless.
At the end of the tenth day, if your account hasn’t been paid it will
automatically be removed. You then
would have to reapply and pay any additional fees to catch up to the thirty day
billing cycle.
You can
cancel your account at anytime. To
cancel your account you must send a written and signed notice of cancellation
and what month you want it to be canceled.
If you do not cancel your services before the first of the month you
will be charged for the full month and may not be entitled to a refund. If you pay by credit card and wanted to
cancel but did not send a written and signed letter to us, your credit card
will be charged until you send in the written cancellation. Failure to complete
your payment term in full, will result in the loss of any discounts associated
with said payment term. Refunds take 2 to 4 weeks to process. This applies to credit cards, check, and cash
accounts. NO
EXCEPTIONS
Applicant’s signature
______________________________
Computer
Central is a Pennsylvania Corporation and is governed by the laws of The State
of Pennsylvania, The County of Beaver, and subscribed and superseded by the
laws of The United States of America, and The United Nations governing bodies
and its use is governed by these bodies.
Computer Central provides connections to the collection of computers
known as "The Internet" and subscribes to the usage as provided for
in the electronic publication known as "Netiquitte"
Internet
connectivity is for use in support of research, recreation, education, economic
development and commerce.
Any
use which violates International, Federal, State or Local laws. Any distribution of unsolicited
advertising’s or mass mailings. The disruption of network traffic or Computer
Central Internet Access services. Chain
letter transmission. Unauthorized access
to systems or data. The reselling of
connection time and or server services pertaining to direct or indirect
connections without prior written authorization.
Computer
Central Internet Access must abide by and comply with all rules and acceptable
use policies of the networks on which it travels. Use of Computer Central Internet Access implies agreement with
the rules as stated herein. Violations
of this policy will result in the termination of service, with no refund of
fees paid to date. Computer Central
will cooperate fully with any duly sworn or authorized law enforcement official
in any investigation as to the legal use of this system. End user will comply
with any and all connection limitation that ccia.com and ccia.net have
currently in place. See www.ccia.com/connections.html for current
detailed list of connection limitations. Residential customers may not run
servers of any type. End user assumes all risk for signal quality. Computer
Central is not responsible for signal loss due to foliage, buildings, weather,
and Radio Frequency interference.
Computer
Central reserves the right to make corrections or additions to this policy.
In Witness whereof, the
parties have entered into this agreement this _______ day of ____________, 2002.
___________________________
____________________________
Customer (Please Print) Computer Central Representative
___________________________
____________________________
Customer Signature Representative Signature
WIRELESS INFORMATION SHEET
Web-MAIL is used to send or receive
information from other users on the Internet.
A Web-MAIL ADDRESS is the name used to
identify you on the Internet. Web-Mail
addresses may be up to eight (8) characters with the suffix of @CCIA.NET
PASSWORD - Your password will allow
you to enter the Internet. You may
request a password up to eight (8) characters or C.C.I.A. will assign one
to you.
Each
user is given one Web-mail address free with their wireless account. Additional
E-mail addresses are available for $5.00 each per month. Please
assign a Web-mail address and password for each Web-mail box.
Web-MAIL ADDRESS(ES) AND
PASSWORD(S) REQUESTED
(up
to eight (8) characters each, passwords
have a minimum of four (4) characters)
1.
APPLICANT NAME
________________________________________________
2. USER ID & WEB-MAIL ADDRESS __
__ __ __ __ __
__ __ @CCIA.NET
8 7 6 5
4 3 2 1
PASSWORD __ __ __
__ __ __ __ __
8 7 6 5 4
3 2 1
***If
the Web-mail address that you have chosen is not available, C.C.I.A. reserves the right to assign you an
e-mail address.
COMPUTER TYPE (please choose one) _______
IBM/Compatible
_______ MacIntosh
Customer
IP Address: ___ ___ ___ o ___ ___ ___ o ___ ___ ___ o ___ ___ ___
Radio Mac Address: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___