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

Vumatel Application Form PDF

 

    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 confirm object number / FSAN number / Unknown
    (If unsure don’t worry we will assist in finding this out for you)
    Please confirm package type below

    Vumatel Home Packages

    Please select the option that suits you best.
    Vumatel Home Price Download Upload
    R595R649R789R839R919R959R1099R1119R1309R1339 10Mbps10Mbps20Mbps20Mbps50Mbps50Mbps100Mbps100Mbps200Mbps200Mbps 2Mbps10Mbps2Mbps20Mbps5Mbps50Mbps10Mbps100Mbps20Mbps200Mbps

    Payment Options

    Please select your payment option
    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: *

    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: B2ETECH