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    Upgrade form 2024

    Uploaded by

    Chinniqe Du Plessis
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    Upgrade form 2024

    Uploaded by

    Chinniqe Du Plessis
    10 views1 page
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    Copyright:

    © All Rights Reserved
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    10 views1 page

    Upgrade form 2024

    Uploaded by

    Chinniqe Du Plessis
    Dont

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    SCREAMER TELECOMMUNICATIONS (Pty) LTD.

    2005/004924/07 Job No Office use only

    Services Application Form

    Full Names & Surname

    Telephone No. Email

    Installation Address (Proof


    of address required)

    Suburb/City Postcode
    Debit Order Details for monthly charges selected below

    Debit Order Date Indicate preferred debitorder date: 1st 15th 25th (Select an option)

    Account Holder

    Bank Name

    Account Number

    Branch Code
    Screamer Telecommunication Banking Details for EFT option only
    (E-mail proof of payment to [email protected] )
    Screamer Telecommunications FNB Account no. 63001973618 Branch 210759 Business Current account

    Select your service options


    Description Once off Monthly
    Uncapped Connection Uncapped Mbps

    Screamer Streamer Classic Deluxe

    CPE Insurance @ R22,21 p/m Yes No

    Voice lines R116 p/m, p/number Number of Lines

    Additional Static IP Address @R35 ea. No of IP Addresses

    Advanced Anti Virus @R58 p/month, p/device No of devices

    Internal WiFi extensions @ R1100 each Wi-Fi Extensions

    UPS Power supply Yes No

    Details of combo specials

    Contract Period: Month to Month 6 Months 12 Months 24 Months

    Client Initial: TOTAL (incl. VAT)

    *The estimated lead time indicated above is determined by network coverage, network availability and the specific scope of work required. The lead time may be affected by project dependencies such as Landlord, Managing Agent,
    Body Corporate, or wayleave approvals. The estimated lead time for installation will be approximately one week after signature of this application.

    Compulsory FICA documentation Required


    Submit via email [email protected] or WhatsApp to 064 081 2342
    Individual/Personal Application: Business Application:
    Company registration documents
    Proof of Banking details Banking details
    Copy of SA ID or valid passport Official Company order
    Proof of Address where Certified copies of Members or Directors IDs
    equipment will be installed.

    Please provide the services selected above at the installation address above on the terms and conditions contained hereunder commencing as soon as possible after signature hereof. I
    understand that this application does not become binding on Screamer until a physical inspection has been conducted at the installation site to confirm that the services can be installed
    and/or until the services are activated. If this application is in the name of a company, ndcommitments.

    Signed at on this the day of 20 .

    Sign Print Name

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