Signal receiver request form

You must be registered for the PeakSmart Retailer / Installer program before requesting signal receivers. Register now.

Request up to 20 PeakSmart signal receivers per region for your customers, free of charge. Make sure you check which signal receivers to order for each region on our PeakSmart webpage or by calling 1300 550 766.

Please allow up to 10 business days for delivery. We'll endeavour to deliver your order in full, but it will depend on stock availability.

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Required fields are marked with an asterisk (*).

Contact Details

First name *

Last name

Company name

Phone number Please enter as a 10 digit number with no spaces, eg 0738516000.

Email address

Signal Receivers Required

Far North region Includes but not limited to Cairns, Ellis Beach, Kuranda, Atherton, Mareeba, Babinda, Tully, Innisfail and Caldwell.

North Queensland region Includes but not limited to Ingham, Mt Isa, Townsville, Ayr, Home Hill, Hughenden and Winton.

Mackay region Includes but not limited to Bowen, Cannonvale, Proserpine, Airlie Beach, Mackay, Sarina and Clairview.

Central region Includes but not limited to Rockhampton, Gladstone, Emerald and Biloela.

Wide Bay region Includes but not limited to Bundaberg, Hervey Bay, Maryborough, Eidsvold, Kingaroy and Nanango.

South West region Includes but not limited to Toowoomba, Dalby, Warwick and Stanthorpe.

Shipping Address

Street address PO boxes cannot be accepted.

Suburb/Town

State

Postcode

Special delivery instructions

Terms and Conditions

Acknowledgement

I have read and accept the PeakSmart Retailer / Installer Terms and Conditions (PDF) including Clause 6 Signal Receivers.*

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