I (the reader and duly authorised person) hereby apply for the supply of a network connection and services in accordance with CityLink's standard terms and conditions. I declare that I know of no debt owing to CityLink in respect of previous failure to pay and I agree to pay for all services and connections as set out in the Supply Agreement. I agree to give at least one month notice of intention to vacate, disconnect or reconnect the premises or services.
Installation and monthly fees will be confirmed by CityLink on receipt of this form.