Service Connection Application

Complete this online application to apply for a service connection at Modus Business Estate.

Modus Business Estate
36 Hume Road
Laverton North 3026

Your Details

Tenant or Business Name

Phone (primary contact number)

Email Address

Supply Details

Services Choose your serviceElectricity

Unit Number Choose your unit***Not on this list1A1B1C1D1E1F2A2B2C2D2E2F (disconnected)3A3B3C3D3E3F4A4B4C4D4E4F (disconnected)5A5B5C5D5E5F6A6B6C6D6E6F7A7B7C7D7E7F8A8B8C8D8E8F9A9B9C9D9E9F10A10B10C10D10F11A11B11C11D11F12A12B12C12D12F13A13B13C13D13F14A14B14C14D14F15A15B15C15D15F16A16B16C16D16F17A17B17C17D17F18B18C18D18F19F20F21F22F23F24F25F26F27F28F29F30FCafeCommonMeeting Room

Supply Commencement Date

Year Month Day

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Payment options

Please enter your preferred payment options in the text box below (Bpay direct deposit, Bank Card auto pay or Bank direct debit auto pay).

Do you accept the Terms and Conditions?

• Terms and Conditions are available here

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