CWNet – Local Independent Internet & NBN Provider Bathurst

First Name *

Last Name *

Business Name

DOB *

Service Address *

Suburb *

Postcode *

Preferred Contact Number *

Alternate Phone Number

Email Address *

Confirm Email address *

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Would you like to add another person who can access your account?

Authorised Account Contact

Authorised contact phone number

Authorised contact DOB

Limited - enquire / discuss only Full authority to act on my behalf

Limited - enquire / discuss only

Full authority to act on my behalf

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Selected Plan *

Wireless equipment - A standard installation does NOT include a wireless router or modem. *

NOTE regarding use of existing equipment*

** I understand that where I choose to use existing equipment, CWNet will make reasonable efforts to configure it for use with the service, however compatibility cannot be guaranteed due to possible restrictions or settings applied by a previous provider. A $50.00 service fee may apply where the equipment requires more than basic setup. CWNet cannot provide a warranty on equipment it did not supply. If my existing equipment is not compatible, I may purchase suitable equipment from CWNet or another retailer.

Wi-Fi setup of TV's etc *

Do you currently have an active internet connection. *

Who is your current provider

Please enter your current AVC ID number (this can usually be found on the bill for your current service)

Would you like to add a home phone/landline number ($25.00 per month unlimited local/national calls) *

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CWNet LOYALTY PROGRAM

Would you like us to send out your complimentary Loyalty Card? *

Yes please, I love discounts at local businesses!!

No thank you

If you would like a second card for another adult in your household, please give us their name

I confirm that I am 18 years or older and agree to the CWNet Loyalty Program Terms & Conditions, including receiving occasional program updates and promotional emails from CWNet.

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Contract 1 - I confirm that I have read, understood and accept the current CWNet Customer Relationship Agreement and Standard Form of Agreement available at https://www.cwnet.com.au/tc/ *

Yes

Contract 2 - I agree to the above nominated plan for a minimum term of 1 month. All NBN accounts are billed monthly in advance, with regular invoices issued on the 20th of each month. On the day my service is activated, an initial invoice will be issued for the pro-rata amount covering the period from activation through to the next regular billing date. *

Yes

Contract 3 - I understand that CWNet is required to verify my identity to meet its legal and regulatory obligations. I agree to provide valid identification via this form, together with all required signatures, before my account and service can be activated. *

Yes

Please upload a valid photo ID *

Contract 4 - I confirm that I own the property or have the owner’s permission for any additional NBN equipment required for the service to be installed. *

Yes

Contract 5 - I acknowledge that all monthly NBN payments must be made by recurring direct debit from a nominated credit or debit card. Valid card details must be provided before an NBN order can be placed and kept current for the duration of the service. Alternative payment methods are not accepted except where required by law or approved by CWNet in writing. *

Yes

Contract 6 - I agree to CWNet contacting me by email or phone to set up, manage and maintain my account, and to provide important service information and general announcements. *

Yes

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Word of mouth (please give their name so that we can thank them!) *

Additional comments or questions

CWNet nbn Order

Sometimes our CWNet network isn’t the right fit for every location, but that’s not a problem. We can still get you connected with an NBN service. Just fill out the form below and we’ll take care of the rest.