Astron Communication and Information Services Pty Ltd

Application Form (Mega Save SIM Mobile)

Application Details
Type of Account
New	Existing - Astron A/c number
Personal Details
Title:		Flat/Unit No:
First Name :		House No:
Surname:		Suburb
Date Of Birth:		State
Home Phone:		Post Code
Mobile Phone:		Email
Work Phone:
ID Type		ID Number
Other

Mailing Address

Mailing address:

State: Postcode:

Payment By credit Card

Do you require International Calls or Global Roaming Service Yes No

Connection Details

New Mobile number required:

OR Porting Existing mobile no:

Portability Authorisation Form Signed: Yes No
(You need to download the PDF from the download section, complete and sign the form and fax it to 1300 788 318)

Name of current mobile network provider

Telestra Optus Vodafone Orange other:

Astron Plan	Monthly Charges	Free Call credits	Contract Term	Select a plan
Mega Save $29.99	$29.99	$350	No Contract
Mega Save $49.99	$49.99	$600	No Contract
Mega Save $69.99	$69.99	$1200	No Contract

Acknowledgement:

I warrant that the information in the application form is true and correct and that I will pay all amounts owed to Astron for the services promptly. I authorise Astron to charge my credit card for all amounts owed to Astron when those amounts become overdue and which I have not disputed by giving Astron written notification of the dispute.
I understand that the mobile service will be provided to me on the terms and conditions detailed overleaf.
I consent to the access, use and distribution of information by and to Astron under the terms of the Privacy Act 1988.
By signing below I also acknowledge my understanding of the following key points of my application:
a) The charges for using the service.
b) That there may be some geographical areas where the service will not operate satisfactorily within Australia.
c) My bill payment terms.
That there is an initial credit limit of $350 and once my total usage charge, over the applicable call allowance, is above this limit I will need to make a payment to continue to use the service.

I accept the SIM Terms and Conditions of Astron.