*Subscriber Name	* Last Name	*Username Choices	*User's Password	Local Dial Up #
		1. 2.
*Street Address	*City	*State	*Zip Code	*Telephone
*Current Email Address	*Fax/Beeper/Cellular	*Location Type	Special Instructions	Service Date

Subscription	Monthly Cost	Download Included	Hours Included	Additional Megabytes	Additional Hours	Additional Email	Total Service Selected
GOLD	$39.99	500mb	150	.13	$1.25	$.50

Service Installed	Install & Activation	Additional Installation	Additional Software	Reactivation	Additional Equipment	Additional Email	Deposit	Install Total
Promotion				Invoice Total	Prepaid	Promotion

Date	*Satellite Modem Mac Address	*Satellite Modem Serial Number
Arrived	Left	User Name	Password
Installer #	*PC Make and Model	*Processor/Speed

Form Of Payment	*Space On Hard Drive	*RAM	*Windows Version	Browser	Email
Signal Level		Needs New Satellite			Other Comments
					Subscriber Signed OK to Install & Documentation Form
Total Payment Received	Demonstration Service	Install Email Account	Left Installation Manual

By Signing below, I (the subscriber) understand that I am responsible for the equipment left in my possession.  I agree to purchase AFEXpress Internet access service provided by my provider.  I affirm my understanding that this agreement consists in accepting the conditions in:  1)  The AFEXpress TERMS AND CONDITIONS OF USE FORM, 2)  THIS WORKORDER, 3)  The DOCUMENTATION OF INSTALLATION and ACTIVATION OF SERVICE FORM provided to me before and after the installation of the Satellite modem and servie on my PC.  I also confirm receiving operation literature and having been given a demonstration of the service. *Customer Signature                                                Date

A Satellite modem was installed and AFEXpress Service was installed for the subscriber as described above. *Installer Signature                                                    Date