Name *

Surname *

 Email Address *

Phone: 1300 554 323
Email: info@connectnow.com.au
Internet: www.connectnow.com.au

A Free Service - Connecting Your Utilities Has Never Been Easier!

Connectnow is a simple and convenient time saving service assisting with your Telephone, Electricity & Gas connections to some of Australia’s leading providers. connectnow also provide a range of additional services to compliment your household utilities, such as Internet &Pay TV.

This is a value-added service independent of your tenancy application - you are not obligated to use connectnow.

If you would like connectnow to contact you to discuss any of the above services please tick the box and a connectnow representative will make all reasonable efforts to contact you within one working day of receiving an application. If we are unable to contact you within this period please contact connectnow on 1300 554 323 to ensure connection can be completed by your requested date.

While the connectnow service is FREE, standard service provider connection fees and charges still apply. You pay NO extra charges as a result of using the connectnow service.
Please contact me*
-- Please select -- Yes No
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A) I acknowledge that this is an application to lease this property and that my application is subject to the owner’s approval and the    availability of the premises on the due date. I hereby offer to rent the property from the owner under a lease to be prepared by the Agent pursuant to the Residential Tenancies Act 1997.

I acknowledge that I will be required to pay rental in advance and a rental bond, and that this application is subject to approval from the owner/landlord. I declare that all information contained in this application (including the reverse side) is true and correct and given of my own free will. I declare that I have inspected the premises and am not bankrupt.

I authorise the Agent to obtain details of my credit worthiness from, the owner or Agent of my current or previous residence, my personal referees, any record, listing or database of defaults by tenants. If I default under a rental agreement, the Agent may disclose details of any such default to any person whom the Agent reasonably considers has an interest receiving such information.

B) If section 6 is complete please note that the following terms will apply if you ask us to contact you. Firstly you will be consenting to connectnow Pty.Ltd. A.B.N. 79 097 398 662 arranging for the connection and disconnection of the nominated home services and to providing information contained in this application to the service providers for this purpose. I agree that neither connectnow nor the Agent accepts liability for loss caused by delay in, or failure to connect/disconnect or provide the nominated services. The service will be activated according to the applicable regulations, service provider time frames and terms and conditions once the client has agreed to use the chosen service provider.

I authorise the obtaining of a National Metering Identifier (N.M.I.) on my residential address to obtain supply details. I acknowledge that the terms and conditions of the service provider bind me and that after hours connections may incur additional service fees from service providers. I acknowledge that connectnow Pty Ltd will be paid a fee by the service provider and will be paying a fee to the Agent in respect of the provision of the service being provided to me by connectnow Pty Ltd.

PRIVACY POLICY:

The privacy of connectnow customers is of vital importance to connectnow. You have the right to access connectnow records of your information under the Privacy Act. connectnow will not release your personal information to any third party other than for the purposes of connecting the nominated utility service, unless required to do so under law or government order.

 Declaration Acknowledgement *
Acknowledged