Required fields are marked with an asterisk (*).

Before you begin, please enter your first name and email under user details. This allows you to save your form at any point using the SAVE and EXIT button at the bottom of the page. You'll be emailed a link to come back to complete your form later if needed.

User details

First name *

Email *

Organisation details

Organisation name *

ABN *

Phone *

Email *

Website

Retail authority

AER Retail Authority *

Product *

• Electricity
• Gas

Scheme participant date of effect *

The date you'll start providing services to customers in our jurisdiction.

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