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 This order form is to install a new ADSL Broadband connection from Tassienet.

 To transfer your ADSL from another ISP to Tassienet - click here.

Customer Details
Prefered Salutation:   eg: Mr, Mrs
First name:  
Surname:  
Contact Email Address:   used to send your confirmation details to
Business Phone :   Please tell us at least one business hours contact phone number
After Hours Phone:   optional
Mobile Phone:   optional
Fax:   optional
Broadband Service Number
Please tell us the phone number of the line that you wish you ADSL service to be installed on   please check this number carefully for any errors
Installation Address
Sub Address:   optional (e.g. Flat 2, Unit 3)
Street Number:  
Street Name:  
Street Type:  
Street Type Suffix:   optional
Suburb:  
Town/City:  
Postcode:  
State:  
Plan Selection

Please select your plan
Account Preferences
How would you like us to notify you when your Broadband connection is ready?   SMS Email Phone
Prefered Tassienet Login Username   @tassienet.net.au   (if no preference, leave blank)
Preferred Tassiemail email address, if any. You can have up to five tassiemail.com.au addresses   @tassiemail.com.au   (optional)
@tassiemail.com.au   (optional)
@tassiemail.com.au   (optional)
@tassiemail.com.au   (optional)
@tassiemail.com.au   (optional)
Payment Details - Paid monthly in advance

Tassienet invoices your monthly fees via direct debit to a nominated bank account on the 1st of each month.

Direct Debit each month

Bank Name:  
BSB:  
Account Number:  

Please also read and agree to the Direct Debit terms below.
Terms and Conditions

I have read, understood and agree to abide by these Terms and Conditions and direct debit or credit card debit conditions and verify that I am over 18 years of age.

I agree I do not agree
Submit your application

Please check your application and then submit it to Tassienet

By clicking the 'Submit Order' button this order will be sent to Tassienet.

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