BT Total Broadband - Shareholder Promotion

Claim your Welcome Cheque by filling in and submitting the form below. Order before the 30th of September 2009 and Claim by the 31st October 2009.

PLEASE REFER TO THE T&C's BELOW BEFORE SUBMITTING THIS CLAIM FORM. To qualify for the welcome cheque all orders for the promotion must either be on-line via the dedicated offer page or to the dedicated sales number detailed in your advert and must be placed by the closing date of the offer. Orders to any other BT sale line or directly to bt.com will not qualify.

Your Information

Enter your Name, Address, and Email Address below:

First Name:
Last Name:
Address 1:
Address 2:
City:
Post Code:
Email Address:
	We will send a confirmation to this Email Address.

Order Information

Enter the Telephone Number you are having upgraded to broadband (ADSL Telephone Number) and your unique Order Reference Number (which was listed in the confimation of your order), and your shareholder reference number. This information is required to validate your application.

ADSL Telephone Number:		*Note that this is not your Broadband Talk Tel. No.
	Your telephone number should contain no characters or spaces e.g. 01224123456
Confirm:	Entry is hidden for verification.

Order Reference Number:
	Example: ABC01234567 THIS IS NOT YOUR BT ACCOUNT NUMBER. Alphanumeric only, no spaces, dashes, or symbols. You will receive an automatic e-mail response once you complete this form which you should retain and send in any future correspondence with BT. However if you have entered incorrect information and your claim cannot be verified then you will receive no future response to this claim or welcome cheque.
Confirm:	Entry is hidden for verification.
Shareholder Reference Number:

Terms & Conditions

• If you need any help or assistance on any aspect of filling out this form, please email affiliate.feedback@bt.com.



• You will receive an automated e-mail response once you submit your cheque request. If you do not receive your cheque within 28 days please send a copy of this automatic e-mail response to: affiliate.feedback@bt.com.



• Claims for a welcome cheque must be within 28days of your broadband being activated.



• To qualify for this offer you must be a residential customer.



• To qualify for the welcome cheque all orders for the promotion must either be on-line via the dedicated offer page or to the dedicated sales number detailed in your advert and must be placed by the closing date of the offer. Orders to any other BT sale line or directly to bt.com will not qualify.



• A cheque will be issued to you within 28 days of your Broadband from BT being activated providing that your claim has been validated and the online claim form has been completed correctly. The cheque will be made payable to the BT account holder at the billing address you give.



• Only 1 welcome cheque can be redeemed against each Broadband connection from BT.



• Only 1 welcome cheque can be redeemed per household.



• Access to Broadband from BT is subject to technical limitations.



• BT's standard terms and conditions apply, see www.bt.com for information.