Applicant Details

Title : Customer Surname : Customer Given Names : Property Name : Are you a Reachnet customer? : Date of Birth :
e.g. 20 08 1987   / / Customer ID Number :

Whats this? Licence Number : Installation Address :
(not PO Box)  

Street number and name


Suburb State Postcode
Billing Address :


Street number and name


Suburb State Postcode
Phone Number(s) :

Contact Phone Number


Mobile Phone Number
Current Email Address : Email Address Preference :

Reachnet Plans

The following plans are offered and are available from July to November 2011. Please select your plan below and complete the application form.

These plans are offered on a 12 month contract. Your data usage will be shaped to 64/64kbps until the end of the billing month when your usage exceeds the monthly allowance. Peak data is available between 12 noon and 12 midnight (AEST/DST). The peak speed of your NBN satellite service will vary depending on location, modem signal quality and normal network traffic flows.

Computer Requirements

Your computer must have an Ethernet port and an operating system of at least Windows 2000 standard to be able to connect to the network:

Standard Installation

NBN Co will install satellite equipment at your eligible property including a modem and antenna and as long as you qualify for a standard installation, NBN Co will pay for the equipment and the installation. This equipment remains the property of NBN Co. In the event of a non-standard installation you will be given the option to pay any additional costs involved, you will not be obliged to proceed with the installation.

Roof Type

--None-- Iron Slate Tile Timber Tin Tin / Tile Other

Power Type

Payment Method

Payments for your service are deducted automatically monthly in advance and you can chose payment by credit card - Visa or MasterCard only, BPAY, EFT, cheque or money order.

You may also choose to pay by cheque or money order. If you select this method of payment, we require your payment to be a minimum of six months in advance.

Select Preferred Method :

Confirmation

This is an electronic application, to confirm your acceptance of the terms detailed please enter your current email address below as indicated:

My current email address : Please re-enter your email address :

If a current Reachnet customer recommended you please would you enter their site id or account number below:

Referrer: We need to have your NBN Co Customer Declaration form as soon as possible so that we can process your application and get you installed and up and running - we cannot complete the process without it.

Please send the form to us at:

Email:		help.desk@orionsat.com.au (fastest)
Fax:		08 6313 5499 (Next best)
Mail:		Reachnet PO Box 3109 Hay Street East Perth WA 6892

For any other information, please contact us on 1300 798 007

By confirming your email address you are agreeing to these terms and conditions

1. I hereby apply for an NBN connection with Reachnet as indicated in this application form.
2. I acknowledge and agree that:
   1. I will supply Reachnet with a valid and signed Declaration Form that has been issued by NBN Co.
   2. I may be required to provide further information or documentation to substantiate this order or any statement made therein.
   3. I may be asked to participate in Program and/or Service evaluation activities.
   4. The Service must be paid for in advance. If my account is not in credit, the Service may be suspended or terminated in accordance with the Reachnet Terms and Conditions.

I agree that this agreement is bound by the Reachnet Terms and Conditions.

Application Completed

Thank you, your form is now submitted to Reachnet.

Please make sure that you mail your Customer Declaration form to:

For any other information please contact us on 1300 798 007.