Openserve Application

PROMO Code

Full Name *

Phone *

Email Address *

ID/Passport Number *

IDPassport

Address *

Select ProvinceGautengEastern CapeFree StateKwaZulu-NatalLimpopoMpumalangaNorth WestNorthern CapeWestern Cape

Full Name *

Phone *

Email Address *

ID/Passport Number *

IDPassport

Company Details

Company Address

Select ProvinceGautengEastern CapeFree StateKwaZulu-NatalLimpopoMpumalangaNorth WestNorthern CapeWestern Cape

ID Document

Proof of Residence

Company Registration

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

New Installations Only – Not Previously Installed Home* - FREE Installation; FREE Activation and FREE to use Router – Valid until 30 September 2024 – Subject to a Minimum Commitment of 6 MonthsIf Already Installed, FREE Activation and FREE to use Router - Subject to a Minimum Commitment of 6 monthsFaulty previously installed ONT or move of ONT R1250 will be payable on order. FREE Activation Fee and FREE to use router with a Minimum Commitment of 6 months
** Services cancelled prior to the initial 6 months minimum commit will be billed R750 Including VAT for an early cancellation **

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: *

Contact Number: *

Date: *

Payment Instructions due in December may be debited against my account on: *