Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Gecko Plan *

Select your Gecko plan

Rural Wireless Unlimited ($99/month)

Phoneline *

I don't need a phoneline

I'd like a Gecko phoneline - $5/month

I'd like a Gecko phoneline with voicemail and CallerID - $7/month

Number Porting

Only complete this if you are requesting a Gecko Phoneline.

I want to bring my number to Gecko

I'd like a new phone number

Current provider

I have existing services at this address and want to bring them to Gecko

I do not have services at this address and want a new connection

Installation *

I understand that the cost for a new Gecko installation is $399 incl GST. This includes travel to site, labour and consumables to install the equipment, a radio dish and a router. After signing up, you'll be prompted to pay for this upfront. If no payment is received and the work is completed, an invoice will be issued for the $399 charge. If the install is particularly complex, we may need to use additional resources or consumables to get the job done. We'll let you know if this is the case, and you'll have the option to cancel the signup if you wish to.

Yes, I understand

How do you wish to pay?

I'd prefer to self-manage payments thanks

I'd like a direct debit setup

111 Contact Code *

Gecko Broadband is committed to supporting all customers, particularly those who are most vulnerable. In the event of a power cut, some services we provide to you (such as landline phones) may not work. If you have certain disabilities, a medical condition or live in a household where family harm is a concern, you can apply to become a vulnerable customer. Gecko will work with you to provide alternate means of contacting emergency services should power supply be suspended to your premises. If you think this applies to you, we recommend visiting our dedicated 111 Contact Code page below. Additionally, select the 'I'd like more information' option when continuing this application. www.getgecko.nz/111-contact-code

I have no medical, family or disability reasons to declare myself a vulnerable customer.

I would like to complete a vulnerable customer declaration form, or would like more information.

Terms and conditions *

I have read, and accept, Gecko's Terms and Conditions

Termination of services *

I understand that 30 days notice is required for the termination of services by Gecko