Packnet Forms

Ethernet order form

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Installation details - Site

Contacts details

Title *

Forename *

Surname *

Contact number *

Email address *

Company details

Company name *

Address details

Postcode *

Address line 1 *

Address line 2

Town / City *

Installation details - Location

NOTE: Once the order has been submitted, any amendments to the site location details will causes delays to the order.

Termination location details

Floor location *

Room location *

Point location *

Is the ADVA to be rack mounted? *

Yes

Is there up to 3U of space available in the rack? *

Yes

Rack U position *

Installation details - Install date

Is a specific install date required? *

Yes

Site readiness & access

Contact's & provisioning details

Technical contact's details

Title *

Forename *

Surname *

Contact number *

Email address *

Order update contact's details

Same as the technical contact's details

Title *

Forename *

Surname *

Contact number *

Email address *

Secondary order update contact's details

Same as the technical contact's details

Title

Forename

Surname

Contact number

Email address

IP address allocation

Number of IP addresses required

Solution options

Email address to send usage statistics to *

Email address to send maintenance notifications to *

Order acceptance details

Full name *

Job title *

Terms and conditions

To complete your ethernet order, please read and confirm you agree to the below.

I confirm that I have read and agree to the terms and conditions.