KonnectTV
  Call Us 1300 797 012
 
Home >> Download Forms Family Entertainment Pack Registration Form
Please fill the details
 
Application Form
Subscriber Information
Title :
First Name :
Last Name :
Date of Birth :
Address :
Suburb :
State :
Post Code :
Select Region Metro Regional
Contact Information
Tel (Home) :
Tel (Work) :
Mobile :
Email :
I would like to receive updates on my mobile and email : Yes No
Package
Family Entertainment Package : Family Entertainment + PTC Punjabi :
Service Requirement
Smartcard only :         Decoder+Smartcard :

Full Installation (circle one) : Roof     Wall     Pot Plant  
                                                                                         $100 charge if the dish moves and the installer has                                                                                          to come and align the dish; and                                                                                          $150 for 2 visits pot plant relocation will be                                                                                          applicable
Activation only :   Decoder + Smartcard Realignment :
Property Details
Property Details : House: Townhouse : Apartment
Property is : Property is Owned :   Rented :
Approval letter provided : Yes No
Storey :
Total Storeys :
Identification
Identification Details : Driver's Licence : Medicare : Passport :
Document No. :
Month's Promotion (If Any):
Month's Promotion :
Referred By (Name)
Name :
Contact No. :
Contract Description
Contract :- 12 Months 24 Months No Contract
Declaration (My2010)
  1. I acknowledge I have read; and accept the terms and conditions provided to me by Konnectv. to more details... click here
  2. I understand that I am entering into a contract and initial and monthly charges as per the Konnectv Rate Rard - MY2010 will be applicable. to more details... click here
  3. Decoder+Smartcard only - I understand that I have my own equipment and Konnectv is responsible for service issues (if any) related to the Decoder+Smartcard only.
  4. Smartcard only - Konnectv is only responsible for any service issues related to the card only.
  5. Pot plant/Roof Installation - I will be charged the initial amount even if I am not able to get signal for any reason and agree to pay service charges for any future service issues (if any).
  6. I understand that all equipment belongs to Konnectv and will be returned at the time of termination of service.
I accept all the terms & conditions
Subscriber Signature
Subscriber Name :
Date :
 
 
 
Home | Forms | Tv schedule | Support | Advertise | About Us | Contact Us | Sitemap