Store Internet & Phone Order Form Please enable JavaScript in your browser to complete this form.Purchase Order NumberRequester DetailsPlease enter the details of the person filling out this form. The details will be used to confirm the purchase order, updates and notifications. TitleMrMrsMissMsMstrDrFull Name *FirstLastEmail *Mobile *PO invoice to *Chatime HQ NSWChatime WAChatime store detailsStore Name *Store Email AddressStore Address *Address Line 1Address Line 2CityNew South WalesVictoriaQueenslandWestern AustraliaSouth AustraliaTasmaniaAustralia Capital TerritoryNorthern TerritoryState / TerritoryPostalUpload POD Click or drag a file to this area to upload. A Proof of Occupancy document can include any one of these: – Lease – Rental Agreement – Contract of Sale – A utility bill with your name and address on it (must match the address we are connecting) – Letter of confirmation from a nursing home (on appropriate letter head) – Statutory declaration* from the property owner and the rent receipt from the new occupant – Statutory declaration* from the property owner and the bond payment receipt – Letter from the real estate agent and the rent receipt from the new occupant – Letter from the real estate agent and the bond payment receipt. Please send through pages which include all these details: – Full name – Service Address – Lease/rental commencement date or settlement dateWho will be operating the store?Store *Company StoreFranchiseFranchise DetailsPlease enter the details of the Franchisee who will be operating the Chatime store. The details below will be used for billing and contact purposes.Company Name *Franchisee registered company name.ABN *https://abr.business.gov.au/Name *FirstLastBilling Email *Mobile *Phone *Billing Address *Address Line 1Address Line 2CityNew South WalesVictoriaQueenslandWestern AustraliaSouth AustraliaTasmaniaAustralia Capital TerritoryNorthern TerritoryState / TerritoryPostalCHATIME SERVICE PACKAGESNBN *Easy Chatime Package 1Easy Chatime Package 2Easy Chatime Package 3Easy Chatime Hardware OnlyEasycom NBN includes Unlimited Data. Average Speeds on NBN 50/25 is 43Mbs, Average Speeds on NBN 100/40 is 82Mbs. Service prices is billed at 30 day basis and exclusive of GST. No Lock-in contracts, Month to Month Basis.Phone Number Status *New Phone NumberPort Existing Phone NumberExisting Phone Number *Upload current phone bill Click or drag a file to this area to upload. In order to successfully Port number to Chatime network please provide the most current Phone Bill. Hardware & IT SupportUpfront Hardware & Service Costs *Draytek Vigor2866LAC, Yealing W76P Base+W56 IP Handset. NBN Installlation Comms Electrician Setup to store IT Installatron and Store Setup Support. Hardware, Account Setup, Configuration and Delivery - $ 2,827.00Installation Only (No Hardware) - Includes NBN, IT and Comms Electrician Services - $ 1,210.00No services required - $ 0.00Onsite Installation covers all requirements to ensure internet services are established and working on the store local network. Total store setup costsPrice inclusive of GST.Total Costs$ 0.00 Submit
