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UBB CUSTOMER INFORMER
UBB Broadband Sign Up Form
Complete this form and our team will contact you back once they have assessed the options for your address.
Personal or business details
*
Indicates required field
Name
*
First
Last
Business name
*
Account billing name
*
Address for service
*
Landline contact number
*
Mobile number
*
Email address
*
Contract holder date of birth
*
Contract holder drivers license number
*
Service you require
Service
*
-
Rural fixed wireless
Urban fixed wireless
RBI 1 4G wireless
Home fibre
Business fibre
Any of the above
Phone service
*
-
Yes
No
Building / installation info
House type
*
Single story - low pitch roof
Single story - high pitch roof
Double story - low pitch roof
Double story - high pitch roof
Use of current providers mount & cable
*
Yes - the installer can use the existing providers cable
No - this cable must not be used or removed
Unsure - our installer can discuss
Property obstacles we need to be aware of
*
Trees or hedges
Out lying bulding's that potentially block LOS
Other - please include in comments
Is removal or trimming of trees impeding LOS possible
*
Yes - discuss this with the installer
No - This is not an option
Unsure - our installer will discuss the options
Important details about your homes that may impact your installation
*
Staff Broadband - on farm services
Is this a staff broadband connection?
*
Yes
No
Farm, dairy shed or property name
*
House name/number for connection
*
Ruralco details
Ruralco member
*
No
Yes
Ruralco card name
*
Ruralco number
*
Business or personal card
*
Business
Personal
Submit to have a real person call you back