TELECOMS SERVICES APPLICATION
Highrise Telecoms Pty Ltd
ABN 86 168 668 531
Suite 25, 100 New South Head Road
EDGECLIFF 2027
Business Name
ABN/ACN
Manager Details
Telephone
Your Details
C/Postal Address
Suburb
State
Contact Name
Contact Title
Contact Email
Email for Billing [if different]
Postcode
Site Address
Service Details
Service Details
Key Terms
(additional to T & C’s)
NBN – Voice/Data
Numbers/References
Location ID
LOC
The services provided by HIGHRISE Telecoms are supplied not only on the Terms & Conditions of Supply but also for
an agreed Term. Such Term in this instance will be the period no less than 24 months starting from the date the
services are connected. Such Term is explicitly agreed between the Customer and HIGHRISE Telecoms and it’s noted
that agreed Early Termination Fees will apply if this Agreement is terminated before the end of the designated period.
The Customer hereby applies for Next Services in accordance with this New Service Application Form and does so on
behalf of itself and any related bodies corporate and by signing this Application in the Section below the Customer
confirms: (1) it has the authority to do so and (2) understands this Agreement is also governed by the Terms &
Conditions including the Privacy Section 8 & Credit Check Section 10 and can refuse Services without reason.
NBN Voice access charges are $44.50 per month.
NBN Data access charges start at $80.00 per month.
Call Rates for this Agreement: Local Calls at 12 cents per call, National Calls at 10 cents per minute, Calls to Mobiles at
22 cents per min, Calls to 13/1300 at 36 cents per call.
All rates are ex GST.
Signatures
Signature
Date Signed
Name
Title (if applicable)
Contract us on 1 300 55 30 35 or [email protected]