Vumatel order form

Vumatel order form
Name*

First NameLast Name
Company name
Optional (For business)
Installation address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
ID or Passport Number*
Email*
example@example.com
Invoice made out to
Optional (For business)
Vat number
Optional (For business)
Phone Number*
Please enter a valid phone number.
Payment method*

Debit orderEFT
Installation: free Ruijie Router: R780.00

1) Router payable within 24 hours of installation. 2) Pro-rata services to be paid within 24 hours of receiving the invoice. (Bank details below) 3)First 30m of cabling is free, a quote will be provided by the contractor for any excess cabling required. 4)All Monthly Subscriptions are due in advance and by the 1st of every month.
Please tick your chosen package below:*

30/30mbps @ R488pm50/25mbps @ R628pm50/50mbps @ R838pm100/50mbps @ R888pm100/100mbps @ R938 pm200/200mbps @ R1048 pm
Signature

Clear
Capitec Business Account
Account Name: Blaze Internet
Acc Number: 105 453 9600
Type: Cheque / Current
Branch Code: 450105
Should be Empty:

Installation: free Ruijie Router: R780.00