NBN-EE Order Submission Ready to Connect? Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Internet Speed Required(Required)100/100 Mbps250/250 Mbps500/500 Mbps1000/1000 MbpsSpeed Classification(Required)Your speed classification will determine the cost of your service, premium will guarantee your selected speed however will be priced accordingly. Standard – Speed at Best Effort (Recommended)Premium – 1:1 Guaranteed speedNTU Hardware(Required) I have my own equipment I require new equipment Important Information to Read Critical Information Summary Terms & ConditionsDate of Birth MM slash DD slash YYYY Best contact number(Required)Email(Required) UBT Account # Additional NotesTerms & ConditionsConfirm Terms & Conditions(Required) I agree to Terms & Conditions Authority to Complete(Required) I authorise this order to be submitted on my behalf by a UBT Telco Staff Member Δ