WIRELESS TO THE SUBURB FORM

Suburb Wireless

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
Last
ADDRESS FOR FIBRE TO BE ACTIVATED
ADDRESS FOR FIBRE TO BE ACTIVATED
City
State/Province
Zip/Postal

Please select a package option from our 12 month or 24 month contract options.

FTTS - 12 month contracts
FTTS - 24 month contracts

PLEASE NOTE:

Setup includes one point of connectivity. Any additional points in the home to increase connectivity will be an additional cost and quoted accordingly.

FIBRE SETUP

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
BILLING ADDRESS
BILLING ADDRESS
City
State/Province
Zip/Postal
ACCOUNT TYPE
TERMS AND CONDITIONS

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