I wish to apply for Rocket Broadband Services. I am authorised to act on
behalf of the
business or residence on this matter. I have read, understood and accept the terms and
conditions detailed at
payable in advance. I am over 18 years of age.
Originator's address: Skytel Networks Ireland Ltd, M2 McConnell Business Hall,
I instruct you to pay direct debits from my
account at the request of Skytel Networks Ireland Ltd. The amounts are
variable and may be debited on various dates. I understand that if any direct debit is paid
which breaks the terms of
instruction, the bank will make a refund. I understand that Skytel may change the amounts
and dates only after giving
prior notice. I understand that if any direct debit breaks the terms of this instruction,
the bank will make a refund.