Application Form Intercom

NGV Telephone & Broadband Application Form

Date of application (required)

Date service required (required)

Step 1 - Billing & contact details

First Applicant
First Name (required)

Surname (required)

D.O.B (required)

Are you? MaleFemale

Second Applicant
First Name

Surname

D.O.B

Are you? MaleFemale

Install Address (required)

Mailing Address (required)

Mobile Number (required)

E-Mail

*Please see attached terms and conditions or visit our website at www.ngvwifi.com.au.

Step 2 - Security

To ensure your privacy you may be asked to identify yourself with personal information.
This may include any such information you provide on this application agreement, however for added security, please choose a question that only you will know the answer to: e.g My place of birth.

Question

Answer

NGV Phone Plans

Step 3 - Standard PhoneYesNo

Intercom only rental - $15p/mPensioner line rental - $20 p/mStandard line rental - $30 p/m

Local calls: 18c unlimited

National calls: 16.5c per min

Australian mobile calls: 33c per min

13/1300 calls: 35c per call

International rates: From 11c per min (plus 5c flag fall) to Belgium, Canada, China, France, Spain, Germany, Hong Kong, Netherlands, New Zealand, UK and USA.

Would you like?

White Pages Listing? YesNo

Call Wait Enabled? YesNo

NGV 101 Voicemail Service? YesNo

*For additional costs and information please check the terms and conditions.

Step 4 - Phone Combos YesNo

Unlimited national, local, 13/1300 calls - $10 p/m *Mobile calls not includedUnlimited mobile, national, local, 13/1300 calls - $20 p/m

International calls are not included for any combo.

Connection fee for setup of a new NGV service is a one off charge of $100.

Step 5 - Internet YesNo

Getting a phone service with us too?

We will take $30 of all of our unlimited plans if you are also getting a Unlimited Combo special.

We will take off $10 off any internet plan if you get a Standalone Phone with NGV.

50Gb Download500Gb DownloadUnlimited

Select a Plan

15/5Mbps Down/Up - $40p/m25/5Mbps Down/Up - $50p/m50/20Mbps Down/Up - $60p/m

Select a Plan

15/5Mbps Down/Up - $50p/m25/5Mbps Down/Up - $60p/m50/20Mbps Down/Up - $70p/m

Select a Plan

15/5Mbps Down/Up - $70p/m25/5Mbps Down/Up - $80p/m50/20Mbps Down/Up - $90p/m

Do you require a wireless AP/modem/router?

Yes - $90No

Please specify make and model of AP/modem/router you will be using

Make

Model

Please be aware your own modem/router may not be compatible with your new service and cannot be supported by NGV, please call if you are unsure.

Internet password? (This is required to allow you to access information regarding your data, including usage). Must be minimum 8 characters long

WiFi Password? This is only required if you have requested a new modem/router. Must be minimum 8 characters long. (This password allows you to connect your devices wirelessly to your NGV internet service)

New wireless AP/modem/router: $90

*For additional costs and information please see the terms and conditions.

** Speeds indicated are best effort.

If a technician is required to visit your premise to complete your internet connection there is a one off charge of $100.

Step 6 - Direct debit

By providing my credit card details, I hereby agree and give Next Generation Voice Pty Ltd permission to charge and debit my credit card for the duration I have services with Next Generation Voice Pty Ltd.

Debits will occur on a monthly basis on the invoice due date. I understand I am able to cancel this direct debit at any time by providing notification in writing to Next Generation Voice Pty Ltd.

If my contract states it is mandatory I pay my account by direct debit, I understand that by cancelling my direct debit I am also cancelling my services. No refund is applicable for cancellation of services that occurs prior to the billing date.

Please fill in the details below and confirm that you accept our agreement.

Are you paying your account by direct debit?

YesNo

Card Number

CVC

Expiry - Month

Expiry - Year

Signature

Step 7 - Invoice delivery options

Would you like to receive your bill by email

YesNo

Step 8 - Signature and acceptance

I request the supply of the above services on the terms & conditions and customer agreement provided.
I warrant that all information in this application is true and correct. If I am an individual applicant I consent under the Privacy Act 1988 (Cth), to the access, use and disclosure of information by NGV in any circumstances not prohibited by the Act. I warrant that I am NGV’s customer in respect of the services.
If the Customer is a company, signatory hereby warrants that he/she is duly authorised to sign this
application on behalf of the Company.

Applicant 1 Full Name

Applicant 2 Full Name

Date

To return your completed application you can email it to us at: provisioning@ngv.com.au or mail it to us at: 1/37 Expansion St, Molendinar, QLD 4214 or alternatively return the completed form to your community manager and they will pass it on to us.

Signature

General terms and conditions

You may be able to keep your existing telephone number. To check if this option is available for you, please contact us on 1800 007 648 Monday to Friday during the hours of 8:30am to 4:00pm (excludes public holidays) or email us at: provisioning@ngv.com.au
Special Service Numbers beginning with 19 are NOT available from this service, this includes competition lines.
Some Telstra services such as *10# and 1234 are not available from this service.
NGV provides support services for Internet related issues between the hours of 8.30am and 4pm, Monday to Friday only.
This excludes public holidays. The contact number for support is 1800 007 648. After hours support available for emergencies only.
NGV charges a monthly access fee which includes a specific amount of Data. This data is consumed by the user when
receiving emails, downloading data and general Internet usage. NGV reserves the right to downgrade the speed of a user’s
connection when their limit is achieved.
Limitations of the service: NGV will use reasonable commercial endeavours to provide a continuous service. However, makes no guarantees that access will be available at all times and, to the extent permitted by law, will not be liable for any losses whatsoever that may be incurred as a result of the unavailability of the Service. You acknowledge that there may be a reduction in availability during periods of maintenance and enhancement of the Service The installation of the services may cause temporary interruption to current Internet provision or telephony services.
The NGV service can be connected to a Switch or Wireless Router to service multiple PC’s.
NGV is not responsible for malicious attacks by Virus, Trojans & Worms which may cause the user’s computer to be damaged or require repair. All PC protection software is the sole responsibility of the end user.
Service connection fee is a one off $100 charge.
If a tech install (site visit) is required, an additional $100 charge will apply, please contact our office if you are unsure if you will require a visit.
The minimum service contract is 1 month, there is no lock-in period and you are free to disconnect your service after the first month.
New connections will be pro-rata from the date that the service is connected.
Pensioner rates apply for any customer over 60 or if you currently hold a pensioner / senior’s card.
All prices stated on this application form are inclusive of GST.
For full terms and conditions please visit our website at: www.ngvwifi.com.au
The Principal Carriers that own the networks that NGV utilise to provide consumers their agreed services are Telstra, Vocus Communications, AAPT, Exetel and Superloop.