Business Customer Information Form In order for us to create your company on our system, please can you fill out the information below. Step 1 of 6 - Personal Info 0% What can we call you?* First Last What email address can we use?* Enter Email Confirm Email What number can we contact you on?*ID Type*RSA IDPassportRSA ID Number*Passport Number* Registered Company Name*Company Trading Name*Company Registration NumberIs your company VAT registered?*YesNoCompany VAT Registration Number* Thanks for giving us your company details. Please choose the service that you'd like us to provide. Choose the connectivity you require*FibreWirelessFibre Connectivity*10 Mbps20 Mbps30 Mbps40 Mbps50 Mbps70 Mbps100 Mbps200 Mbps500 Mbps1 GbpsOtherWireless Connectivity*10 Mbps20 Mbps30 Mbps40 Mbps50 Mbps100 MbpsOther Awesome! We now need some address details from you to know where you want to get connected.Is your office in a complex / building?*YesNoUnit / Office Number*Building / Complex NameAddress* Street Address Address Line 2 City Province Postal Code Service Address*Do you want your service at the above address?YesNoService Address: Unit / Office Number*Service Address: Building / Complex NameService Address: Address* Street Address Address Line 2 City Province Postal Code As part of our Legal Compliance process, we need to RICA you as a client. Please provide us with a certified copy of your ID / Passport and Proof of Address (not older than 3 months).Upload Documents Now*YesNo, I'll email themNo, I'll provide them during installationRegistration Document / ID Document / Passport*Accepted file types: jpg, pdf. At last! We just need to verify that you're actually human, and for you to accept our T's and C's before we can proceed.Are you a robot?I hereby confirm that I am duly authorised to act on behalf of the Company above* Yes No Do you accept the Terms and Conditions?*They can be found here. Yes No CommentsThis field is for validation purposes and should be left unchanged.