AIR FIBRE FORM Air Fibre Business By filling in the below form, you are confirming consent to your personal data being processed for the Solid Fibre order form purpose as described below. Please make sure all required fields are filled in. Required fields are marked with an asterix. (*) NAME * NAME First First Last Last EMAIL (TO BE USED FOR BILLING PURPOSES) * PHONE * ADDRESS FOR AIR FIBRE TO BE ACTIVATED * ADDRESS FOR AIR FIBRE TO BE ACTIVATED ADDRESS FOR AIR FIBRE TO BE ACTIVATED ADDRESS FOR AIR FIBRE TO BE ACTIVATED City City State/Province State/Province Zip/Postal Zip/Postal AIR FIBRE PACKAGE OPTIONS Please select a package option: SPEED PACKAGE: 10 MBPS DOWNLOAD/ 5 MBPS UPLOAD 12 Months - R 749 20 MBPS DOWNLOAD/ 10 MBPS UPLOAD 12 Months - R 999 30 MBPS DOWNLOAD/ 20 MBPS UPLOAD 12 Months - R 1199 PLEASE NOTE: Drumblade, Eikenhof, Tedderfield and Walkerville areas only. A site survey will be to be conducted to confirm connectivity feasibility. The setup comprises a single connectivity point, featuring a radio, dish, and a 1.5-meter pole, complete with 20m of CAT 5 cable. Any extra points required within the household to enhance connectivity will incur additional charges, which will be quoted accordingly. AIR FIBRE SETUP MONTH TO MONTH - R1999 Once-off. Includes Router, Installation Cable, Installation Labour. Radio will remain the property of Solid Fibre MESSAGE We as a company, would advise our customers to sign up with our Debit order facility. The Debit order simplifies the billing process. If you select the EFT option. Please note we will charge an additional R50.00 per month for Administration purposes. If payment has not been received by the 1st of the billing month, your account will be suspended and once payment has been received, we will charge you a reconnection fee of R80.00. In a case where your debit order bounces the, reconnection fee will apply. PAYMENT OPTIONS * DEBIT ORDER FACILITY EFT (ELECTRONIC FUNDS TRANSFER) BILLING ADDRESS * BILLING ADDRESS BILLING ADDRESS BILLING ADDRESS City City State/Province State/Province Zip/Postal Zip/Postal COMPANY NAME (IF BEING USED FOR BILLING PURPOSES) VAT NUMBER BANK BRANCH BRANCH NUMBER ACCOUNT HOLDER ACCOUNT NUMBER ACCOUNT TYPE SAVINGS CURRENT TERMS AND CONDITIONS * I agree to the terms and conditions of the service subject to the completion of the ordering process. Submit If you are human, leave this field blank.
