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Broadband Sign Up
"
*
" indicates required fields
Step
1
of
2
50%
Account Contact
Is the Connection for Business Use?
*
Yes
No
Company
*
Name
*
First
Last
Phone
*
Email
*
Privacy Policy
*
I agree to the
privacy policy
.
Service Address
Address 1
*
Address 2
Suburb
Town/City
*
Region
*
Postcode
*
Plan Selection
Broadband Plan
*
ADSL
VDSL
Fibre 300
Fibre Max
Broadband Plan
*
VDSL
Fibre 300
Fibre Max
Preferred Connection Date
*
ASAP
Choose a date
Date
*
DD slash MM slash YYYY
Current Internet Provider & Account #
*
Type “none” if you don’t have internet yet
Static IP
(Most people don’t need this)
No, I don’t need a Static IP
Yes, I need a Static IP ($6/mo)
How did you hear about us?
*
Service Agreement
*
I agree to the service agreement, and I have the authority to open an account with the details provided.
Name
This field is for validation purposes and should be left unchanged.