Order Opticomm Internet

Address

Address Line 1

Address Line 2

City

State

Postcode

Title

First Name

Last Name

Your email address

Mobile number

Alternate number

Date of Birth

Drivers License number

Are you transferring from another provider or is this a new connection?

Transfer

New

Utility bill

Choose File

To process an Opticomm order we need a proof of occupancy document such as a water or electricity bill, or rates notice. This is due to an Opticomm requirement.

Broadband Plan Selection

Preferred connection date

Router required?

For more information about our routers click this link (It will open in a new tab)

This router in included with your plan free of charge provided you stay connected with us for 12 months. If you leave or cancel early there is an early termination charge of $5.50 per month remaining as a lump sum on your last invoice. i.e. 3 months remaining = $16.50

I have read and agree to the Terms and Conditions and Privacy Policy

I have read and agree to the Critical Information Summary

Did someone refer you to us?

No

Yes

Please let us know who so we can thank them with a credit. Refer others and you can earn the same!

Account Payment method

Credit Card

Direct Deposit

Bank

Account Name

Bsb

Account Number

Card Number

Unfortunately card fees do apply (Direct Debit is free):

1% for Visa or Mastercard

3% for Diners Club or American Express.

Expiry Date

CVV