Customer InformationBUSINESS BROADBAND E-MAIL APPLICATION FORMHKTPage 1 of 2Company Name:BR No.:Contact Person:Administrative Contact Name:Account No.:Contact Tel No.:Tel/Mobile No.:E-mail Address:Fax. No.:A. New E-mail Registration(Please note that migration is required if the domain name change from Leased Line to Business Broadband Service.)The number of characters for an e-mail login should between 2-15 characters. All characters should be in lower cases. No special characters such as#, $, * etc is allowed. It should begin with an alphabet. The number of characters for a domain name "login@domain" should be less than 36 characters.The login ID will be auto-assigned if your preference is not applicable. It takes 5 working days to activate E-mail account or roaming service.Login ID first ChoiceLogin ID second ChoicePreferred Alias@domain EmailFax Roaming(Within 15 characters)(Within 15 characters)Example:you@yourdomain.com( Please Tick for activate )1 @2 @3 @4 @5 @6 @7 @8 @9 @10 @E-mail Login for activating Admin Function:(Please fill in Administrative Contact information above)Please tick if you are a existing Message@work subscriber.** EmailFax number only apply for Message@work subscriberB. Existing E-mail Modification(Please note that migration is required if the domain name change from Leased Line to Business Broadband Service.)Please tick for the appropriate service requirede.g.12345678910Delete Modify√ActivateRoaming√DeactiveEmailFaxDeactiveRoamingLogin IDmod001Existing E-mail Address/EmailFax no.(for modification or deletion use only)New Mail Address/EmailFax no.** EmailFax number only apply for Message@work subscribermod@abc.com.hknewmail@abc.com.hkService Request Date 2 :For Internal use only YES NoQ1. Is the above login ID related to any service plan of PCCW? e.g. B3, B10 plan of NETVIGATOR [ ] [ ]Q2. Would you like to terminate those login ID which are not mentioned above ?[ ] [ ]Q3. Would you like to change the service plan currently subscribed ?Please also summit a termination form for termination.[ ][ ]
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