Abel VISP  
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 Wholesale ADSL Orders
You are now in a secure area. Upon submission your order will be processed.
* denotes a mandatory field
 1. End User Details as on BT Bill for ADSL Telephone Number
 Title:
 Address:
 *
 First Name:
 *  
 Last Name:
 *  
 Company Name:
 Postcode:
 *

 2. VISP Domain Name - e.g., "visp.co.uk"
 3. VISP Purchase Order Reference
 Domain Name:
 *  Purchase Order Reference:
 *
 4. ADSL Package Required
 5. Telephone Number to be ADSL-Enabled
 ADSL Package:
  *  xDSL Line Telephone Number (no spaces please):
 *

 6. Period of Subscription - Yearly or Quarterly
 Frequency:
  *

 7. Account Name to be ADSL Enabled - e.g. "bloggs.visp.co.uk"
 8. Your Comments
 Account Name (in format of bloggs.visp.co.uk, not just "bloggs"):
 *


Payment: In advance by cheque or BACS.

Declaration: I hereby order ADSL activation for the above telephone number. I confirm that I have read and understood the Terms & Conditions of Abel VISP and Abel Always and agree to be bound by both said Terms & Conditions.

Advice: You are recommended to print a copy of this page.