Customer Details

First Name *Last Name *Phone *Email *Are you the: * Select an optionOwnerTenantRetirement Living ResidentWhich service do you need connected: * Select an optionElectricityGas / Hot WaterBothCustomer Identification (Please Select Identification:) * Select an optionDrivers LicencePassport

Account Information

Supply Commencement Date * NOTE: Please provide a minimum of two business days’ notice so we may organise connection. What is your preferred contact method? (Invoices and general communication) * Select an optionEmailPostDo you wish to be an active participant in our automatic debit arrangement? * Select an optionNoYesIf YES: Please fill out the Direct Debit form (available here)Are you eligible for Government concession? * Select an optionNoYesIf YES: You will be required to provide a copy of your concession card.Does any occupant at this address require electricity for life support reasons *: Select an optionNoYesIf YES: Please fill out the Life Support Registration form (available here)

Supply Address Details

Unit Number *Building Number *Street *Suburb *State *Select an optionSAVICNSWQLDWANTTASACTPostcode *

Postal Address

Is your postal address different from above? *: Select an optionNoYesNOTE: If postal address different please fill out the below section.[group postal]Unit Number Building Number Street Suburb State Select an optionSAVICNSWQLDWANTTASACTPostcode [/group]

Requested File Uploads *

ClearPDF or JPEG files only. Photo and customer identification details need to be visible in supplied Australian drivers licence and passport image.

Authority Agreement

When you click “I Agree & Submit”, you agree with the following:

• I have read through the Energy Terms & Conditions and understand my obligations as a customer of Savant Energy.

• I have provided the required documents and forms to support my application.

• I understand that to close my account, I need to provide Savant Energy with 5 days’ notice.

• I have been provided information relating to the operation of the embedded network at my address and am fully aware of my electricity purchasing options. I acknowledge that I give consent to becoming a customer of Savant Energy.