• How it works
  • Application form
  • Confirmation

Your Contact Details

First Name
Last Name
Company (optional)
Email Address
Contact Phone Number
Alternative Contact Number

Postal Address

Street
Suburb
City
Post Code*

Billing Information

 Same as above
First Name
Last Name
Company (optional)
Email Address
Contact Phone Number
Alternative Contact Number

Postal Address

Street
Suburb
City
Post Code

Energy Retailer

Energy Retailer
Account Number with Energy Retailer

Account holder contact details

 Same as applicant contact details
 Same as billing contact details
First Name
Last Name
Contact phone number
Email Address

Postal Address

Street
Suburb
City
Post Code

Site Details

If you have lodged an application with Orion already, please ensure that you have nominated us as your livening agent.

If you did not nominate Safepower, please contact Orion on 0800 363 9898 and request the job is allocated to us. You will need to provide Orion with your Es application number.

Orion ES Number (if blank, we will apply on your behalf)

Site Address

Street Number
Street
Suburb
City
Post Code

If the site does not have a street number allocated, please enter the Lot and DP numbers

Lot
DP
Number of Lease Boxes Required
Lease box connection type We recommend a permanent connection for new house builds
Size of lease box connection

Standard connection size for lease box is single phase 60 amps – sufficient for most builds

Size of final connection Standard connection size for house is single phase 60 amps – consult your electrician if unsure
Water Heating
Preferred Lease Box Install date
Preferred Lease Box Livening date
Estimate Rental Period
Preferred rental fee

Electrician Details

Name
Company
Email
Contact Number

Anything Else?

If there is anything else you would like us to know about your site or any unusual requirements you may have, please enter them below.

Supporting Document (e.g. site plans, this is optional)
 I agree to be bound to the Safepower Services Limited terms and conditions when leasing a power box. If I am applying on behalf of my customers I acknowledge that they have also read and agreed to these terms and that I have authority to accept on their behalf.

You can read our terms and conditions here.