registration form

Thankyou for choosing Jump Internet as your Internet Service Provider.
Please complete and submit the electronic form below so we can evaluate the present level of service to your area.

Report Form

Date of Report:	Day: Month:
Name:
Postcode:
Connection speed:	bps (mouse over the computer icons in the tray)
# Dial up attempts:
Drop outs:

Please enter any questions or comments you think may be relevant: