About
Coverage
Order
Business
Residential
WiFi
FAQs
Contact
Order Form
Residential Service Order Form
Forename
*
Your forename.
Surname
*
Your surname.
Address Line 1
*
We need your address for your paperwork and signal planning.
Address Line 2
Town/City
Postcode
*
Phone
*
We may need to contact you for connection purposes (We only contact you about your connection so no telesales calls!)
Email
*
We will contact you by email to update you about your service.
Whos your current broadband supplier?
Let us know who your current provider. You can check your speeds at www.speetest.net
Your current download speeds?
Mbps
Your current upload speeds?
Mbps
Package Details
Symmetris Package
*
The package you require.
Symmetris Lite
Symmetris Lite +
Symmetris Home
Symmetris Home +
Symmetris Pro
Symmetris Home Ultimate
Router
*
Your connection will allow 1 computer to connect if you'd like to connect more than 1 device you'll need a router (some ADSL routers will work with our system) but Symmetris will only support routers supplied and installed by ourselves.
I do not require a router (I understand Symmetris will not support my router)
I require a router £25.00 (payable upon connection). The engineer will deliver, install and configure it. Symmetris will support it whilst you're subscribed.
I am unsure please advise on connection.
Referrer
We sometimes offer an incentive to referring customers. So if a Symmetris customer put you onto us let us know!
Acceptance
Terms and Conditions
*
I have read and accepted the
Terms and Conditions
and the
Fair Use Policy
I agree and accept the Terms and Conditions and Fair Use Policy
Connection Day
*
I understand on the day of connection I will need to pay for my connection and my 1st months subscription. I understand I can pay by BACS or the engineer by cheque or cash (The office will email a receipt). Once connected you will receive an email with Standing Order payment details.
I agree
Customer Premises Equipment
*
All equipment installed remains the property of Symmetris Broadband Ltd. I understand if I do not allow removal of the equipment on cancellation or in the event of non payment I will be charged £150.00
I agree
Comments
Verification
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