Astron Communication and Information Services Pty Ltd

Application Form ( Call Saver )

This form must be completed by the telephone account holder of your household.
Your Details			Your Address
Title:			Flat/Unit No:
First Name :			House No:
Middle Name:			Street Name
Surname:			Suburb
Date Of Birth:			State
Home Phone:			Post Code
Mobile Phone:			Email
Work Phone:
ID Type			ID Number
Other

Call Saver – Please fill in your telephone number(s) that you would like to register for this service.

Is the telephone in your name ? Yes No
Current Carrier Telstra Optus AAPTPrimus Other
If no, you need to get the actual account holder to complete this form.

1.	2.	3.

“Convenience Dialling” option - you can opt for this option by filling in your most often called International number(s) for $1 per month for each of your chosen number.

	Name of Country	Country Code	Area Code	Local Number
1.
2.
3.
4.

Acknowledgement:

I certify that the telephone number is registered in my name and I have the authority to register for this service.

I agree to join Astron’s Call Saver service subject to the provisions of Astron’s terms and conditions overleaf.

I understand that any calls made from my registered home telephone to Astron’s Call Saver access number will be invoiced to me by Astron each month and that I will pay these charges on the due date.

I also understand that the cost of calling Astron’s Sydney access number, either from Sydney or outside Sydney, will be billed by my current service provider and it is my responsibility to pay to them.

For “Convenience Dialling”, if opted, I further agree to pay $1 per month for each of the chosen numbers. Calls made from the chosen number(s) will be invoiced to me by Astron each month.

I shall pay for all the call charges made from them by me or any person that I have authorised to use on the due date.

Full Service Transfer authorization if applicable:

I authorise Astron to make arrangements with my current telephone company for the transfer of lessee of my lines and accounts to Astron.
I understand I will still be responsible to my current telephone company for any charges which are incurred and billed up to the date the transfer is effective.
I acknowledge that I may surrender all incentives and benefits with my current telephone company.
The telephone service number(s) will be transferred with their current status. I will contact my current telephone company in relation to providing services and any faults until the transfer is effective.
I certify that nobody in my household requires priority or emergency services from Telstra for health or medical reason or suffers from a medical condition which may require emergency service, as Astron cannot provide such service.

I accept the Terms and Conditions of Astron.