To cancel your account print out this form and fill it in with your details and post it to the address shown below.
Note:This must be sent by Australia Post and cannot be faxed or emailed.
Any received by fax or email will be invalid and will not be accepted as cancellation of your account.
As per our terms and conditions section 9.8 If you cancel your account or move to another provider all of your account details including your login username and password, email accounts and any information will be deleted from our system during the monthly billing/accounting cycle canellation period. We are not obliged to inform you that all information (including email accounts) will be deleted from our system after  receiving your cancellation form. 
Attention:Accounts Administrator
Intertech Country, 2 Beech Street  Mount Gambier, SA 5290

re: Cancellation of Account   Dialup  [     ]   - ADSL Broadband  [     ] -  Wireless (USB)  [     ]
(please note: you must be the primary account holder in order to canel your account)

I, ........................................................... ................................ (account holders real name)  (Please Print information)
wish to cancel my Internet Account by giving you notice as specified in your Terms and Conditions.
http://www.icisp.net.au/conditions.html  

My username is: .............................................@icisp.net.au  

My password is:......................................

(please use the left side address section if you are not moving. If you are moving to a new address, city, or travelling around please fill in both address sections

Drivers Licence No: ............................  Date of Birth: ...............................

Telephone: (0   ) ................................. Mobile: .........................................

Reason for cancelling account:

................................................................................................................................................................................

.............................................................................................................................................................................................................................................

As the primary account holder I understand that there are no refunds for unused portions of services, this includes fees paid in advance for Block Hours, ADSL, Dial-Up and Web Hosting services and that cancellation of my account does not remove my responsibility to pay all fees incurred up to and including the date of cancellation.

Signed.............................................................      

Print name:.......................................................

dated this day: .................................................  office use: date received:     /      /       :    date account closed:      /      /