Mobile Voice Plan Sign Up

Select a Mobile Plan (required)

Please select the plan you would like the service connected on.

Port or New Number (required)

I want to port my mobile number

I want a new mobile number

Do you already own a mobile number you would like to use or would you like a new number allocated for this service?

Mobile Number (required)

Pre-Paid or Post-Paid (required)

Pre-Paid

Post-Paid

Is your mobile number on a pre-paid (top up) plan or a post-paid (account) plan?

Pre-Paid Date of Birth (required)

Pre-paid services require a Date of Birth for authentication. In order to port the mobile number we require the Date of Birth associated with the service. Inaccurate information will delay or prevent the port process.

Account Number with Losing Carrier (required)

Post-paid services require the current account number for authentication. In order to port the mobile number we require the Account number associated with the service. Inaccurate information will delay or prevent the port process.

Title (required)

First Name (required)

Last Name (required)

Email address (required)

Are you an existing QTelecom customer (required)

Yes

QTelecom Account Number (required)

Daytime Phone (required)

Date of Birth (required)

Drivers Licence Number (required)

Service Address (cannot be PO Box) (required)

Billing Address (required)

Same as Service Address

Different to Service Address

Billing Address (required)

Other Information

The applicant named hereby declares: (required)

Confirmed

I am the applicant whose name appears on this Application. I am the lessee/authorised person of the mobile telephone service for which I am applying to be connected on. I have read, understood and agree to be bound by QTelecom’s Standard Terms & Conditions. I understand QTelecom may exchange information with a credit reporting agency, to obtain a consumer credit report about me, and/or to allow the credit reporting agency to create/maintain a credit information file containing information about me. All the information I have provided in this Application is true and correct.

Type the characters (required)

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