Standard Registration

User Registration Standard

Please provide us your contact details to allow us to process your order.
AVT Direct will review the details submitted by you on your child and reply via email, as to whether your child is eligible.
In this email you will receive the link with which you may then proceed to purchase the Standard Tier.

First Name

Last Name

Phone/Mobile

Password

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

I confirm that my child has been fitted with hearing devices(hearing aids/ cochlear implants/ Baha Softband).