Certified Partner Online Wireless Application

Please use this form to submit an application for Clever fixed wireless broadband.

The details provided within this form will be sent to your account manager, who will create a service schedule for you to review and approve before processing the order.

PARTNER DETAILS
Partner Name:(*)

Invalid Input
Contact Person:(*)

Invalid Input
Contact Number:(*)

Invalid Input
Email:(*)

Invalid Input
END CUSTOMER DETAILS
Company Name:(*)

Invalid Input
Street Address:(*)

Invalid Input
Suburb:(*)

Invalid Input
State / Postcode:(*)

Invalid Input
Contact Person:(*)

Invalid Input
Contact Number:(*)

Invalid Input
Mobile:(*)

Invalid Input
Email:(*)

Invalid Input
SERVICE DETAILS
Wireless Speed:(*)

Invalid Input

*For speeds 20M and above, speak to your account manager for pricing and specifications.
Service Type:(*)

Invalid Input
Rooftop access?(*)

Invalid Input

If a technician arrives on site to install a service and access is not permitted, or access is delayed, a site visit fee known as a DTOW will be charged at $250.00 ex GST.
Contract Term:

Invalid Input
PLAN DETAILS - Refer to wholesale price book.
Installation $:(*)

Invalid Input
Access per month $:(*)

Invalid Input
Included GB:

Invalid Input
Excess/MB $:

Invalid Input
CPE Required?(*)

Invalid Input
If Yes, CPE Model:

Invalid Input
CPE Cost $:

Invalid Input
Premium SLA?(*)

Invalid Input

If Premium SLA is selected, this will be provided at $40.00/month.
IP ADDRESS AND LAN DETAILS
IP Address:

Invalid Input

Unless specified by you, Clever will assign default IP addressing as -/30.
LAN IP Address/Mask:

Invalid Input

If Clever has supplied the router, provide the LAN IP Address/Mask.
Notes:

Invalid Input

Place information for VLAN Requirements/IP Addresses/POI for Layer 2 Tails/Inter-Capital links/Other General comments here.
AUTHORISATION: I hereby apply for Clever Communications Australia services and acknowledge that the service will be provided subject to the provisions of Clever Communications Basic Carriage Service Tarriffs including Clever Communications Terms and Conditions applicable to the Telecommunications Service (both as amended from time to time) made pursuant to Part 9 Division 5 of the Telecommunications Act 1991. I acknowledge that the Clever Communications Service is provided on the basis of the customer network dimensions included in this application. At any time, should the actual network requirements vary, Clever Communications will consult with me to determine my new requiremenets. I further acknowledge that if the IP Addresses provided to me are not registered, at a subsequent time I may be required by Clever Communications to modify any or all of these addresses. I confirm that I have read and agree to be bound to the Service Agreement between Clever Communications Australia and our Company.
Authorisation:(*)

YesNoInvalid Input
Press 'submit order' to email your application to your account manager. A service schedule will be prepared for you to check the details of your order and sign your authority to proceed.