TurboNet Application - Residential P h i l i p s b u r g - Te l : 5 4 3 6 8 8 8 - F a x : 5 4 3 7 9 5 0 - E m a i l : i n t e r n e t @ s i n t m a a r t e n . n e t • w w w. s i n t m a a r t e n . n e t CUSTOMER INFO Account # Last Name: First Name: Address: Tel.Home: Tel.Work: Cell: Email for billing: WORK INFO Company Name: Company Address: Company Phone: Cell: Fax: Position in Company: Email: GENERAL INFO Telephone # for this connection: User Name: Operating System: Package Password: (16 chars max) WinME Win2000 DSL US $ Post-Paid ANG Post-Paid US $ WinXP Pre-Paid ANG (6 or more) WinVista Pre-Paid US $ MacOS9 MacOSX Set-up (Administration Fee) DSL Only (New Acct) Starter 128/256K 24.99 88.98 49.99 71.18 39.99 Lite 256/512K 44.99 124.58 69.99 106.78 59.99 512K/1MB 59.99 151.28 84.99 133.48 74.99 Regular 763K/2MB 155.99 322.16 180.99 304.36 170.99 Turbo 763K/4MB 254.99 498.38 279.99 480.58 269.99 Dial-up to TURBO (Special) ANG 0.00 $ 0.00 Ultra 763K/8MB 499.99 934.48 524.99 916.68 514.99 (DSL and Line) ANG 225.00 $ 126.40 Basic ANG 100.00 $ 56.18 Pre-Paid (DSL and Line) ANG 225.00 $ 126.40 DSL to Turbo (Existing) ANG 0.00 $ 0.00 SPECIAL NOTE This internet connection requires a computer with a minimum of 256 MB of RAM, a 10Base-T Ethernet Network Card. Telnet cannot be held responsible for problems resulting from the lack of any of these requirements. The actual throughput (download) speed that you experience will vary and may be lower than your connection speed after accounting for factors such as the length and condition of your telephone line; the condition of wiring inside your location; computer configuration; telephone network or Internet congestion; and the server and router speeds of websites you access, among other factors. Not all customers qualify for all speeds. Additional terms or conditions may apply. Additional information available upon request. All fees must be paid at the beginning of the month. Prices are subject to change. In case of non-compliance with the general terms and conditions and/or arrears of payment, customers will be disconnected from all the services provided by TelNet and Telem. Customers will receive one monthly bill which will include the fees of all the services provided by TelNet and Telem AUTHORIZATION All applicants must adhere to the terms and conditions stated in the TelNet Communications Acceptable Usage Policy and TelEm Group Terms and Conditions. I acknowledge system Requirements Signature: Date: REV 3-30-07