PO Box 20

Business NBN Application Form

 Chadstone  3148
Phone:  03 9885 4655
  Fax:  03 9885 1455

 Contact Information

Company:
Name:
Address:
Suburb: Postcode:
Phone: Fax: Mobile:
Email:

 Plan Type

Speed Capacity Monthly Fee
12M/1M Unlimited $77
25M/5M Unlimited $105
100M/40M Unlimited $132
   Notes:
  • No basic setup cost
  • A service fee of $35 applies where the speed of the service is altered
  • To determine service availability, check online at nbn co
  • Minimum term 36 months
  • Prices include GST
  • Critical Information Summary

 Credit Card Direct Debit Authorisation

 VISA  MasterCard  American Express  Other
Card Number: Expiry: /
Card Holder's Name:

 Agreement

I agree that the above details are true and correct. For credit card payment, I understand that my credit card will be debited for all set-up charges and monthly in advance for the access fee. Once connected, I agree to abide by the terms and conditions found at https://i.net.au/agreement/ or available on hardcopy upon request. This form must be signed if submitting by hardcopy. The signatory must be at least 18 years of age.
 I Agree
              Name                             Position                             Signature                       Date