Internet Service Application Form

Welcome to Betta Family

We empower communities and businesses
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Date

MonthDayYear
Date
I* do hereby authorize Betta Technologies to install an Internet Link at my property.
Term of Contract*

12 Months24 Months36 Months
Signature*

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Below are the Betta Technologies payment details

Bank: FNB/RMB
Account Holder: *Betta Technologies (pty) Ltd
Account Type: Gold Business Account

Account Number: 62837747651
Branch Code: 250655

Please note that currently we accept bank transfer and cash deposit. No Debit order is in place. Thank you

NB:For all Terana Wireless installation there is a once off R750.00 installation fee that will be charged. For OpenServe Fibre there is no Installation fee required

Welcome to Betta Family