Internet Registration Form

Internet Registration Form

Internet Package Registration

Thank you for choosing us.
Select Your Package*
Please select your package that you want to install
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address Map Locator
Message
Terms and Conditions
By signing this document you agree to our terms and conditions as set out at https://www.delmasconnect.co.za/terms-of-use/

You agree that all outstanding invoices will be paid by no later than the last day of the month in which the invoice was created. If payment is not received by this date, all services will be suspended until such time that the account is paid in full.

You also agree that a full calendar month notice will be given upon cancellation and that all invoices will be paid before services are suspended.
Please sign below to accept all terms and conditions*
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