Internet Only Order Form

Section A. Existing Account

Existing Account Number:

If you’re already a Fantel customer. Please enter your Fantel account number here.

Section B. Service Address

Enter the service address where the internet will be connected to.

Service Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Section C. Billing Address

If the billing address is the same above just put a tick in the checkbox, otherwise, please enter all fields below correctly.

same as above

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Section D. Contact Details

Details entered here will become the authorised account holder.

Your Name(Required)

First Last

Account holder’s name.

Date of Birth(Required)

Required for security purposes

Driver's Licence

Phone(Required)

This is used so that we can contact you.

Mobile

Email(Required)

Company Name

ABN / ACN

Section G. Shaping

Please select your option(Required)

Shape the connection to 256kbps/256kbps when data allowance is reached

I accept excess data usage charges $11/GB thereafter.

Section H. Modem Router

D-Link DVA-2800

TP-Link VG5612

Router Purchase

D-Link DVA-2800 $198.00

TP-Link VG-5612 $143

Section I. Service Details

Enter the telephone number where the ADSL Internet is to be activated on.

Service Number(Required)

Enter your existing telephone number here and please include the area code.

Section J. Term

Choose The Contract Term(Required)

1 months $ 199.00

12 months $ 99.00

24 months $ 0.00

Section K. The Plan

Choose Your Plan(Required)

Your minimum monthly cost: $27.95

Critical Information Summary

Your minimum monthly cost: $39.95

Critical Information Summary

Your minimum monthly cost: $59.95

Critical Information Summary

Total Cost Upfront

*If your premise is outside of our on-net service region, a $16.50 per month surcharge will apply.

Section L. Agreement and Authorisation

By submitting this form you agree to the following:

I have read, understood and agree to abide by Fantel’s Terms and Conditions.

I authorise Fantel to direct debit my credit card the amount on the invoice at the time the invoice was generation.

Section N. Comments

Your Message