Connection Application

Note: Only Low Voltage (LV) connections - less than or equal to 1000 volts including all Low Voltage embedded generator connections should proceed with this application form.

To complete this form, please refer to the Connecting to the Network Information Pack available at essentialenergy.com.au/connecting.

A form submitted with incomplete/illegible information cannot proceed.

All High Voltage (HV) connections, 1000 volts and above, including generator connections are required to follow the process summarised in the Connections Process for HV customers and Embedded Generators which is available at essentialenergy.com.au/hv.

Note: Your application for connection or alteration will form the technical schedule to your connection contract.

Is the Application being completed on behalf of the customer? If not go to Section 1.1 Customer Details

Section 1.0: Applicant Details
Relationship with Customer*		Select one Retailer ASP/Electrical Cont/Installer Real Estate Developer Other
Business Name
Title	Select one DR DR & MR DR & MRS EST OF MESSRS MISS MISS & MISS MISS & MR MISSES MR MR & MISS MR & MR MR & MRS MR & MS MRS MRS & MISS MRS & MR MRS & MS MS MS & MR MS & MS Mrs & Mrs The Manager The Trustees	First Name * (Please provide first name if not business)		Surname
Unit or Flat No		Street No
Street Name
P.O. Box * (Please supply PO Box if street no and street name not provided)
Town / City*		State*	Select one Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia	Postcode*	Postcode Finder
Best Contact No*
Email*

Section 1.1: Customer Details
Title*	Select one DR DR & MR DR & MRS EST OF MESSRS MISS MISS & MISS MISS & MR MISSES MR MR & MISS MR & MR MR & MRS MR & MS MRS MRS & MISS MRS & MR MRS & MS MS MS & MR MS & MS Mrs & Mrs The Manager The Trustees	First Name * (Please provide first name if not business)		Surname/Business Name*
Unit or Flat No		Street No *		Lot No
Street Name *
P.O. Box * (Please supply PO Box if street no and street name not provided)
Town / City*		State*	Select one Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia	Postcode*	Post Code Finder
Best Contact No
Email*
Retailer Name	Select one STANRET COZERO ENERGY RETAIL AUSTINL BOCO ROCK WIND FARM MACQUARIE BANK SOUTHHYD ESNRGY COMMANDER POWER AND GAS POOLED ENERGY PTY LTD POOLED ENERGY PTY LTD NSW POOL CONNECTION POOL SNOW NEXT BUSINESS ENERGY AGL SOUTHERN HYDRO (NSW) PTY LIMITED TARALGA WIND FARM NOMINEES P/L JAKGREEN NIGHTVSN QTSC GOENERGY QENERGY ALNTABUS SIMPLY ENERGY - IPRETAIL PROGRESSIVE GREEN SANCTUARY ENERGY MBC AGL SOLARIS ACTEWAGL RETAIL AES POWERDIRECT ORIGIN BORAL ORIGIN ENERGY ELECTRICITY LIMITED ORIGIN CITIPOWER DELTA ELECTRICITY ENERGY AUSTRALIA ERGON ENERGY ENERGY ONE ENERGEX SUN ORIGIN INTEGRAL ORIGIN POWERCOR PULSE AGL SALES STANWELL ENERGY AUSTRALIA EASTERN ENERGY AUSTRALIA YALLOURN AGL GAS LUMO ENERGY VIC ERMPOWER AURORA ENERGY MOMENTUM ENERGY NEIGHBOURHOOD ENERGY AUSTRALIAN POWER AND GAS RED ENERGY CLICK ENERGY LUMO ENERGY NSW LUMO ENERGY QLD SANCTUARY ENERGY DODO POWER AND GAS AUSGRID LUMO ENERGY SA DIAMOND ENERGY ENDEAVOUR ENERGY AGL SALES SIMPLY ENERGY - ENGYAVIC APG BUSINESS ALNTARES ADVANCE NORPOWER INFIGEN ENERGY CAPE BYRON MANAGEMENT COVAU PTY LTD INFIGEN ENERGY BLUE NRG ENGYTIME LMS ENERGY SNOWY HYDRO GUNNING WIND ENERGY DEVELOPMENTS GLOBIRD MOREE SOLAR FARM 1ST ENERGY PTY LTD PACHYDRO PHRETAIL ENOVA ENERGY PTY LTD CULLRGWF URTH Energy Pty Ltd ENGYLOC POWERSHOP AUSTRALIA MOJO POWER YALLOURN HWF3 EASTSGA HORNSPR VICLUMO WINRET YDPSGA SONNEN REAMPED SALUMO ETSAUTIL LMSENE MANILDRA NSWLUMO LANDFILL BRIGHTON SAWCML KIDSTON MERIDSGA HAZELPWR HORNSDL2 TANGO ENERGY PTY LTD SORTED WROCKWF SPARQ DISCOVER QLDLUMO