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 a $50.00 service fee may apply where my existing equipment requires more than basic setup.

* While the technician will make reasonable efforts to use existing equipment, CWNet cannot guarantee compatibility with their network due to possible restrictions from your previous provider.

* I understand that CWNet cannot provide a warranty on equipment they did not supply.

* I understand that 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 be found on the bill for your current service)

Would you like to add a home phone/landline number ($34.95 per month) *

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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 will read and understand and accept the terms and conditions set out in the current version of the Customer Relationship Agreement and Standard Form of Agreement, as linked above and via https://www.cwnet.com.au/tc/ *

Yes

Contract 2 - I agree to the above nominated plan for the minimum term of 1 month and understand that this is to be paid within 5 days of my service being activated. *

Yes

Contract 3 - I understand I will require to provide ID and Signatures prior to my account being activated *

Yes

Contract 4 - I am the owner of the property, or have permission from the owner of the property for any additional nbn equipment to be installed if necessary *

Yes

Contract 5 - I acknowledge that monthly payments must be made via direct debit from a card, with alternative arrangements only available by prior approval in exceptional circumstances, and that card details must be provided before an order is placed with the NBN. *

Yes

Contract 6 - I agree to CWNet contacting me on the email and phone number provided above for the purposes of implementing and maintaining my account, 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.