Pest Cure Service Request

Pest Cure - Here to Help

Please complete all fields and submit the form
Name & Surname:*
Email:*
e.g., xxxxx@gmail.com
Contact Number:*
Steet Address:*
House Number*
Area:*
Please give a comprehensive discription of the problem*
Number of Infested Areas:*
POPIA Terms

Select Yes if you wish to read
POPIA Terms

YesNo
The Protection of Personal Information Act (POPIA) requires that we inform you that the personal information requested from you is necessary for the purpose of providing you with our services. We will use the information provided to us in a lawful and secure manner and will not use it for any other purpose. By submitting your information, you agree to our use of it in accordance with POPIA.
Developed by Altus Klingenberg | CREATE THE CHANGE YOU DESIRE | createthechange3@gmail.com
Should be Empty:

POPIA Terms