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<H1>SALES INFORMATION LINE</H1>
<DIV><SPAN style="FONT-SIZE: 18px"><SPAN style="FONT-WEIGHT: bold"><SPAN style="FONT-SIZE: 18px"><SPAN style="FONT-SIZE: 16px"><SPAN style="FONT-SIZE: 18px"><SPAN style="FONT-WEIGHT: bold"><SPAN style="FONT-FAMILY: Arial; FONT-SIZE: 16px">Customer Service / Technical Support / Faults</SPAN></SPAN></SPAN></SPAN><BR><BR><SPAN style="COLOR: rgb(50,109,169)"><SPAN style="FONT-FAMILY: Arial; FONT-SIZE: 16px"><SPAN style="COLOR: rgb(50,109,169)">Email enquiries: <SPAN style="FONT-WEIGHT: bold"><SPAN style="FONT-WEIGHT: bold"><SPAN style="COLOR: rgb(50,109,169)"><SPAN style="FONT-FAMILY: Arial; FONT-SIZE: 16px"><SPAN style="COLOR: rgb(50,109,169)"><SPAN style="FONT-SIZE: 16px"><A href="mailto:enquiries@switchedonvictoria.net.au"><FONT face=Arial>enquiries@switchedonvictoria.net.au</FONT></A> </SPAN></SPAN></SPAN></SPAN></SPAN></SPAN><SPAN style="FONT-WEIGHT: bold"><BR></SPAN></SPAN></SPAN></SPAN><SPAN style="COLOR: rgb(50,109,169)"><SPAN style="FONT-FAMILY: Arial; FONT-SIZE: 16px"><SPAN style="COLOR: rgb(50,109,169)"><BR>Tel:&nbsp;&nbsp; 1300 455 620&nbsp;&nbsp;&nbsp;&nbsp; Fax: 1300 038 595</SPAN> </SPAN></SPAN>
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<TD style=" TEXT-ALIGN: left;  WIDTH: 680px; HEIGHT: 16px; VERTICAL-ALIGN: middle;  "><SPAN style="FONT-FAMILY: Arial">(<SPAN style="FONT-SIZE: 14px">9am - 5pm Monday to Friday - AEST)</SPAN></SPAN></TD></TR></TBODY></TABLE><SPAN style="FONT-FAMILY: Arial; COLOR: rgb(50,109,169); FONT-SIZE: 16px">Hea<SPAN style="FONT-FAMILY: Arial">d Office </SPAN><BR></SPAN>
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<TD style=" TEXT-ALIGN: left;  WIDTH: 680px; HEIGHT: 16px; VERTICAL-ALIGN: top;  "><SPAN style="FONT-FAMILY: Arial; FONT-SIZE: 14px">Suite 3, Level 4, 10 Queens Road, Melbourne, VIC 3004</SPAN></TD></TR></TBODY></TABLE></SPAN></SPAN></SPAN></DIV><SPAN style="COLOR: rgb(50,109,169)"><STRONG><FONT size=4><SPAN style="FONT-FAMILY: Arial"><SPAN style="COLOR: rgb(50,109,169)"><STRONG><FONT size=4><SPAN style="FONT-SIZE: 16px"><SPAN style="COLOR: rgb(50,109,169)"><STRONG><FONT size=4><SPAN style="FONT-FAMILY: Arial"><SPAN style="COLOR: rgb(50,109,169)"><STRONG><FONT size=4><SPAN style="FONT-SIZE: 14px"><SPAN style="COLOR: rgb(50,109,169)"><STRONG><FONT size=4><SPAN style="FONT-FAMILY: Arial"><SPAN style="COLOR: rgb(50,109,169)"><STRONG><FONT size=4><SPAN style="FONT-SIZE: 16px"><SPAN style="COLOR: rgb(50,109,169)"><STRONG><FONT size=4><SPAN style="FONT-FAMILY: Arial"><SPAN style="COLOR: rgb(50,109,169)"><STRONG><FONT size=4><SPAN style="FONT-FAMILY: Arial; COLOR: rgb(50,109,169); FONT-SIZE: 16px">Postal Address<SPAN style="FONT-FAMILY: Arial">&nbsp;</SPAN></SPAN></FONT></STRONG></SPAN></SPAN></FONT></STRONG></SPAN></SPAN></FONT></STRONG></SPAN></SPAN></FONT></STRONG></SPAN></SPAN></FONT></STRONG></SPAN></SPAN></FONT></STRONG></SPAN></SPAN></FONT></STRONG></SPAN></SPAN></FONT></STRONG></SPAN> 
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<TD style=" TEXT-ALIGN: left;  WIDTH: 680px; HEIGHT: 16px; VERTICAL-ALIGN: top;  "><SPAN style="FONT-FAMILY: Arial; FONT-SIZE: 14px">P.O. &nbsp;Box 7713, St. Kilda Road, Melbourne, VIC 8004&nbsp;</SPAN></TD></TR></TBODY></TABLE></TD>
<TD style=" TEXT-ALIGN: left;  WIDTH: 332px; HEIGHT: 16px; VERTICAL-ALIGN: top;  "><BR><IMG style="WIDTH: 227px; FLOAT: left; HEIGHT: 188px" title=340,170 border=0 src="http://www.switchedonvictoria.com.au/images/D82118415.png"></TD></TR></TBODY></TABLE><BR>
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<BR></H1>
<H1>APPLICATION FORM</H1>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>First&nbsp;Name:</STRONG></FONT>&nbsp;</TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Last Name:</STRONG></FONT></TD>
<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><INPUT onblur="proceedBack = true;" onfocus="proceedBack = false;" maxLength=255 size=35></TD></TR>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Postal Address:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>State:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Postcode:</STRONG></FONT></TD>
<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><INPUT onblur="proceedBack = true;" onfocus="proceedBack = false;" maxLength=255 size=10></TD></TR>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Service&nbsp;Address:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>State:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Postcode:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Date of Birth:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Phone numbers to transfer to <BR>Switched On Victoria Pty Ltd:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Number 1:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Number 2:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Number 3:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Number 4:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Number 5:</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  "><FONT size=2 face=Arial><STRONG>Current retailer:</STRONG></FONT></TD>
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<TD style="BACKGROUND-COLOR: rgb(210,231,240)"><FONT size=2 face=Arial><STRONG>Enquiry Note(s):</STRONG></FONT></TD>
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<TD style="  BACKGROUND-COLOR: rgb(210,231,240);  ">&nbsp;</TD>
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        <td style="text-align:center;width:320px;white-space:nowrap;vertical-align:bottom;">
            <a id="FOOTER_DESIGNEDBY" href="http://www.tell-itmedia.com.au" title="" style="font-size:9px;color:#000000;text-decoration:none" target="_blank">WEBSITE DESIGN: TELL IT MEDIA</a>            
        </td>
        
        <td id="FOOTER_COPYRIGHT" style="color:#000000;text-align:right; padding-right:10px; white-space:nowrap;vertical-align:bottom;">
            © Copyright Switched on Victoria
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        <td id="FOOTER_LASTUPDATED" style="color:#000000;text-align:right; padding-right:10px; white-space:nowrap;vertical-align:bottom;">
             Last Updated:11/10/2010
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