E-Schools' Network

Application for School Membership
New  [    ] or Upgrade  [    ]  Please tick one
 
Please return by fax to 021 683 6766 or post to P O Box 44460, Claremont, 7735
For general information phone 021 683 8719 or technical information phone 021 674 9140

Name of School:			
	
Postal address:		

	Postal Code:  	        Province   	

EMIS Number (10 digits): 		
	
Phone:	(           )		Fax:  (           ) 		

Computer Centre Phone (if applicable):  (           )		

Contact Person/s: 			

Principal			

Network Operating System (if applicable): 		

Date from which service/s to be effected: 		

If New Membership, preferred SchoolMail domain name (first part only) or

if Upgrade Membership, existing SchoolMail domain name: 		

Do you require a SchoolMail Installation CD (Yes/No): 		

Services required:  (Please tick): 	Existing	New	
SchoolMail			
  SchoolMail access via ETRN, requires Dial-up access, static IP			
Standard Dial-up Internet Access			
  ISDN 64K Dial-up Internet Access			
  ISDN 128K Dial-up Internet Access			
  ADSL Dial-up Internet Access max 3GB pm per Telkom limits			
  Leased Line Access via Diginet (specify rate), subject to contract			
  Satellite, requires Diginet access, subject to contract			
Webpage Hosting (free with SchoolMail)			

Please note:  Other than Leased Line and Satellite, subscription billing is done annually in January.   A pro rata billing for current year is effected for new Members.  Written notice of one calendar month is required to cancel services.   This notice to be confirmed by us.

Signed:			School stamp:

Name of signatory:  ___________________ 

Date:                        ___________________