Telephone Line Order Form

Phone Line Order Form

This form to fill out if you only require a standard phone line service.

Section A. Existing Account
Do you have an existing Fantel Account?
- Yes I do have an account with Fantel already.
Existing Account Number:*

If you're already a Fantel customer. Please enter your Fantel account number here.
Section B. Address
Enter the service address where the phone line is or is to be connected
Phone Line Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Section C. Billing Address
If the billing address is the same above just put a tick in the checkbox, otherwise, please enter all fields below correctly.
Billing Address
- same as above
Service Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Section D. Contact Details
Details entered here will become the authorised account holder.
Your Name*
First Last
Account holder name.
Date of Birth*
DD slash MM slash YYYY

Required for security purposes
Driver's Licence
Phone*
This is used so that we can contact you.
Mobile
Email*
Company Name
ABN / ACN
Section F. Service Details
Service Number*
- I have an existing telephone number
- I need a new telephone line activated
Service Number*
Enter your existing telephone number here.
Name on the account*

This is the name on the account where your current telephone provider is billed to.
Your Account Number with current Telephone Provider*

Enter your account number with the current telephone provider here. This number would appear on your bill.
We will assign a new number for you. Please move on to the next section.
Phone Line Rental*
Option
- MessageBank - $6.60 per month
- Calling Number Display - $6.60 per month
- Silent Number - $3.30 per month
Monthly Minimum
$ 0.00
Section G. Agreement and Authorisation

By submitting this form you agree to the following:
Terms and Conditions*
- I have read, understood and agree to abide by Fantel's Terms and Conditions.
Payment Authorisation*
- I authorise Fantel to direct debit my credit card the amount on the invoice at the time the invoice was generation.
Section H. Comments
Your Message

Phone Line Order Form

Section A. Existing Account

Section B. Address

Section C. Billing Address

Section D. Contact Details

Section F. Service Details

Section G. Agreement and Authorisation

Section H. Comments