Only for mobile receiving equipment installed in caravans, mobile homes and the like, work camps and watercraft.

	* - Denotes required information
OWNER'S CONTACT DETAILS
First Name:	*
Last Name:	*
Company (if applic.):
Postal Address:	*
Town/City:	*
State:	Select... ACT New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia *
Post Code:	*
Phone:	*
Fax:
Mobile:
Email:	* A valid owner email address is required for verification and processing. Incorrect contact information will result in the removal of services.
Re-enter Email:
PRIMARY AREA OF TRAVEL
State:	Selecting a state will determine what services are enabled on your decoder. Western Australia travellers are now eligible for WA services. Select... ACT New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia *
Work Camps only Site Address:
DECODER DETAILS
1st Decoder Model:	Select... Multi-service CAM UEC DSD4121
Smartcard Number:	* Finding the Decoder Smartcard?
Extra Information:
Privacy:	VAST Broadcasters are sometimes asked to provide ratings agencies with details of our viewers for ratings purposes.  Do you have any objection them providing your details? YesNo
DECLARATION Tick to confirm I am applying for access to the VAST services using mobile receiving equipment whilst in areas where adequate digital terrestrial television reception is unlikely. I understand that I will be issued with a temporary Reception Certificate to access VAST for a fixed period of 6 months from the date of issue. I understand this Reception Certificate will expire at the end of this 6 month period and the services will be withdrawn. I understand that I may apply for a further temporary Reception Certificate by lodging a fresh application 4 weeks prior to the expiration of the temporary Reception Certificate stating reasons for receiving a further temporary Reception Certificate. (The extension form is available on the mysattv.com.au website or phone 1300 993 376)
	Your decoder may be activated with all the Commercial, ABC & SBS Channels for your area. Please ensure your decoder is turned on and that you can already receive Channel 800. This will ensure that you receive the activation after submitting this form. Your decoder will still receive the activation signals if powered up at a later time, but there may be a delay.
	Please note that decoder registration processing and activation usually occurs within 48 hours of the next business day.