Service Disconnection Form

Complete this online application to disconnect and existing service connection at Conservatory Apartments.

Conservatory Apartments
5 Winton Road
Malvern East 3145

Your Details

Tenant or Business Name

Phone (primary contact number)

Email Address

Supply Details

Services Choose your serviceElectricity

Unit Number Choose your unit11/A22/A33/A44/A55/A6/A7/A101101/A102102/A103103/A104104/A105105/A106106/A107/A201201/A202202/A203/A204/AcommonGateway

Supply Disconnection Date

Year Month Day

JanFebMarAprMayJunJulAugSepOctNovDec1234567891011121314151617181920212223242526272829303120202021202220232024202520262027202820292030

Notes

Please add any extra notes or comments here

Do you accept the Terms and Conditions?

Disconnect My Service Cancel