New Customer Registration Form

New Customer Registration Form
Customer Details:
Full Name & Surname

First NameLast Name
ID No
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Occupation
Company
Gross Salary
Customer Signature
Agent Full Names and Surname

First NameLast Name
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My Products
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22.5 GB + 22.5 GB Capped Telkom LTE
40 GB + 40 GB Capped MTN LTE R299 p/m

299.00 ZAR Quantity



10 Mbps Sim-Only Uncapped Telkom LTE
10 Mbps Telkom Sim Only Unlimited

399.00 ZAR Quantity



Wifi UPS
Wifi UPs for loadshedding

1,099.00 ZAR Quantity



Open Serve Fibre 10/5 Mbps
Unlimited Open Serve Fibre 10/5 Mbps

399.00 ZAR Quantity



Vumatel Unlimited Fibre 10/10 Mbps
Pay once Off Installation of R400 and Pay R299 for your Unlimited Monthly Data

699.00 ZAR



Vumatel Unlimited Fibre 20/10 Mbps
Pay once Off Installation Fee of R400 and Pay R399 for your Unlimited Monthly Data

799.00 ZAR Quantity



Telkom Unnlimited Mifi Lte 10/10 Mbps
Telkom Unnlimited Mifi Lte 10/10 Mbps

Pay R899 Onceoff

399.00 ZAR Quantity



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0.00 ZAR
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