Skip to content
Home
Plans
Order
Coverage Area
Home Phone
Why
Contact
Newsletter
Menu
Please enable JavaScript in your browser to complete this form.
Do you live within 6Klms west of our Mt Grey Tower??
*
Yes- Proceed
No? Please fill out our RURAL application. https://remoteisp.com.au/goulburn-internet/
Not Sure. Give us a Call 0422736683, Option 2, Please do not proceed.
Name
*
First
Last
Date of Birth
*
Just to match your identification that needs to be viewed on the day of installation.
Street Address
*
Suburb
*
State
*
Postcode
*
Home Phone Number
*
Write None for no home phone
Mobile Number
*
Does your mobile phone work at home?
*
Yes - Telstra
Yes - Optus
No
Are you interested in our Unlimited home phone?
*
Yes
No, Yes i know its only $34.95 Unlimited in Australia
Email Address
*
Email
Confirm Email
Residential plan details
*
GT - $79.00 - No Contract, Unlimited Monthly
Installation Costs
*
NBN NOT Ready - $330.00 Payable on installation
NBN Ready - Free Installation
If for any reason we cant install you, you will not be charged.
Would you like a Backup Battery installed?
*
Yes, please pick option below
No, thanks
700VA $199.00
1000VA $229.00
1500VA $269.00
2200VA $368.00
3000VA $999.00
5000VA $2599.00
*Modem and mobile devices. 700VA 20 Mins approx. 1000VA 30 Mins approx. 1500VA 50 Mins approx. 2200VA 70 Mins approx.
Would you like a static IP?
*
YES - $10.00 Monthly
No thanks
Upgraded Wi-Fi, Internal and external
*
No Thanks.
Ceiling Access Point, 120 Meter range, $409.00 at installation
Please onsite quote full WI-FI.
Did a friend refer you ?
Please advise their full name and phone number.
Additional Notes
Do you require a RemoteISP email address?
*
Yes
No
Wi-Fi (ssid) Name
*
Property Name, Last name etc etc.
Password for your Wi-Fi
*
8 characters min. 12 characters max.
Contract 1, I will read and understand the terms and conditions on www.remoteisp.com.au web site set out in the current version at https://remoteisp.com.au/tc/
*
Yes
No
Contract 2, I agree to the above nominated contract term and installation payment method and understand its paid in advanced on the day of the install
*
Yes
No
Contract 3, I understand i will require to provide ID and Signatures on the day of the installation
*
Yes
No
We use and App to capture ID's, Signatures and Photos of the Installation for Quality purposes.
Signature
Clear Signature
Comment
Submit
GT
Home
>
GT
Hits: 0
Close Menu