Service Application Form
1
Customer Info
Customer Info
1/3
Select Prefix
Mr.
Mrs.
Ms.
Miss
Prefix
First Name
Last Name
Email Address
Mobile Number (e.g. 04XX XXX XXX)
Address
Suburb
State
Post Code
Date of Birth
Residential
Business
Company Name
ABN/ACN
2
Order a Plan
Order a Plan
2/3
EzPhone Plans:
AVC ID:
3
Confirm
Confirm Details
3/3
Full Name:
Email Address:
Contact Number:
Address:
Date of Birth:
Customer Type:
Broadband Plan:
Phone Plan:
AVC ID:
Company Name:
ABN/ACN:
I agree to
EzTel's
terms and conditions
.
