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Consumer Application Form

Supporting Documentation (New Customer)
  • Proof of identification: SA ID / Passport (including work permit)
  • Most recent payslip + three months' bank statements
  • Proof of residence (utility bill not older than 3 months)
  • For porting: Account number at donor service provider
Supporting Documentation (Existing Fixed/Mobile Customer)
  • Proof of identification: Copy of SA ID or passport (including work permit)
Sections to Complete
  • New Application: Sections 1, 2, 3, 5A or 5B, 6
  • Change of Ownership: Sections 1, 2, 3, 4, 5A, 5B, 6
  • Porting: Sections 1, 2, 3, 5C, 6
  • Upsell: Sections 1, 2, 3, 5A, 5B, 6
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Client to Complete
Application Type
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Service Required
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Quick Navigation

Since this is not a new application, you can skip the full form and go directly to the dashboard.

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Or continue with the full application form below

Section 1: Customer Details
Existing Customer Information
Personal Information
Contact Information
Physical Address
Postal Address
Delivery & Billing Information
Alternative Contact Person
Section 2: Employment Details
Employment Information
Section 3: Payment Details
Banking Information
Payment Authorization

Payment Signature Upload

Accepted formats: JPG, PNG (Max 2MB)
Section 5A: Broadband Services
Broadband Service Details
Broadband Service Authorization

Broadband Signature Upload

Accepted formats: JPG, PNG (Max 2MB)
Section 5B: Voice Services
Voice Service Details
Voice Service Authorization

Voice Signature Upload

Accepted formats: JPG, PNG (Max 2MB)
Section 6: Agreement & Signature
Terms and Conditions
Consumer Agreement Terms

By signing this application, you agree to the following terms and conditions:

  1. You confirm that all information provided is true and accurate.
  2. You authorize us to conduct credit checks and verify provided information.
  3. You agree to the terms of service and billing as outlined in our standard terms.
  4. You understand that false information may lead to application rejection or service termination.
  5. You authorize debit order payments from the specified bank account.
  6. You agree to comply with all applicable laws and regulations.

Important: Please read the full terms and conditions available on our website before proceeding.

Agreement Signature Upload

Accepted formats: JPG, PNG (Max 2MB)
Section 7: Office Use Only
Application Processing

Office Signature Upload

Accepted formats: JPG, PNG (Max 2MB)