Please complete the online form below, or you can download the application form:

Openserve Application Form PDF

 

    PROMO Code

    Primary Contact Information

    Full Name *
    Phone *
    Email Address *
    ID/Passport Number *
    IDPassport
    Address *

    Billing Contact Information

    Full Name *
    Phone *
    Email Address *
    ID/Passport Number *
    IDPassport

    Company Information

    Company Details
    Company Address
    ID Document
    Proof of Residence
    Company Registration

    Fibre Information

    Is Fibre Installation Required?
    YesNo
    If Installed please supply your Circuit Number:
    When do you require the service to be activated (if installed already):
    Please confirm package type below
    ** Services cancelled prior to the initial 6 months minimum commit will be billed R750 Including VAT for an early cancellation **

    Openserve Home Packages

    Please select the option that suits you best.
    Package Price Download Speed Upload Speed
    R689R799R929R1249 50Mbps100Mbps200Mbps300Mbps 25Mbps50Mbps100Mbps150Mbps

    PAYMENT TERMS - DEBIT ORDER ONLY

    For Debit Order please complete the debit order mandate below.

    Authority and Mandate for payments Instruction: Electronic and Written Mandates

    Given By (Account Holder): *
    Address: *
    Bank Name: *
    Branch & Code: *
    Account Number: *
    Amount: *
    Account Type: *
    Contact Number: *
    Date: *
    Payment Instructions due in December may be debited against my account on: *
    This debit order mandate will be mailed to you for your records, please sign and return to home@activefibre.co.za.
    Abbreviated Name as Registered with the Bank: ACTIVE FIB