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Connectivity OptionsFiber InternetWireless Internet

Wireless Package Options *

INSTALLATION (Please select your equipment payment preference)ONCE OFF12 Months24 Months36 Months

Your Once Off Fee

N$

Your Once Off Fee

N$

Fiber Package Options [ex vat pricing] *

Fiber Installation24 Months36 Months (FREE INSTALL)

Once Off Fee

N$

Your monthly cost (Services for residential customers and natural persons are VAT zero rated.)

N$

Your Monthly Cost (Services for residential customers and natural persons are VAT zero rated.)

N$

Business or Private Use. *PrivateBusiness

Title

First Name *

Surname *

ID Number *

Company Name *

VAT Number *

Telephone Home

Telephone Work

Cell Number *

Email Address *

Fax Number

Street Address *

Town/City *

Suburb *

Installation Address *

Wireless Name (SSID) *

Wireless Password (Minimum 8 Characters) *

Upload your ID *

No file chosen

Upload CC documents *

No file chosen

Signature *

Date

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