Rural Internet Order Please complete this order form and our technicians will be in contact to arrange your install. This form does not guarantee that our service is available in your area, this will be confirmed by our technician prior to your install. If you wish to change the details of your selected plan please call to speak to our accounts team prior to your installation date. Before you complete the order please read the Terms and Conditions and the Critical Information Summary below. Terms & Conditions Critical Information Summary Real Estate permission template First Name * Last Name * Business Name DOB * Service Address * Suburb * Postcode * Preferred Contact Number * Alternate Phone Number Email Address * Confirm Email address * ____________________________________________ Would you like to add another person who can access your account? Authorised Account Contact Authorised contact phone number Authorised contact DOB Authority levelLimited - enquire / discuss onlyFull authority to act on my behalf ____________________________________________ Selected Plan *---I would like to discussBasic $59.00 pm (400GB data, max. 20MBps down, 5MBps up)Medium $79.00 pm (Unlimited data, max. 50Mbps down, 20MBps up)Ultimate $99.00 pm (Unlimited data, max. 70MBps down, 20Mbps up)__________________________________Business 1 $99.00 pm (Unlimited data, max. 50Mbps down, 20MBps up, same day SLA)Business 2 $139.00 pm (Unlimited data, max. 50Mbps down, 20MBps up, same day SLA + 4G backup)Customised Business Plan Modem *---I have existing CWNet equipmentI will require a new modemI would like to check if I can use my modem from a previous service provider ____________________________________________ Referral name ____________________________________________ Contract 1 - I will read and understand the terms and conditions set out in the current version as linked above via https://www.cwnet.com.au/tc/ *YesNo Contract 2 - I agree to the above nominated plan for the minimum term of one (1) month and understand that the plan fee and any non-standard installation costs are to be charged on the day of the install *YesNo Contract 3 - I understand I will require to provide ID and Signatures on the day of the installation *YesNo Contract 4 - I am the owner of the property, or have permission from the owner of the property, for a wall plate to be installed on internal wall of the building, and a mount and small dish to be installed on the roof of the building *YesNo Contract 5 - 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 and occasional promotions *YesNo Additional comments or questions Submit Standard installation does NOT include a Wireless router and or modem No cancelation fees* Service not guaranteed at all addresses, please submit and enquiry to find out if your address is available
