Application for Wireless Application for Wireless Personal DetailsNameID NumberPhoneEmail AddressStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeBusiness Details (If applying for company)Business NameRegistration NumberVAT NumberPhoneWebsitePostal AddressBanking DetailsAccount HolderAccount NumberSelectAccount TypeCurrentSavingsChequeTransmissionBankBranch CodeProduct SelectionWireless Internet (Choose One)Select *Wireless Internet1Mbps @ R249(Uncapped)2Mbps @ R379 (Uncapped)3Mbps @ R479 (Uncapped)4Mbps @ R569 (Uncapped)6Mbps @ R719 (Uncapped)8Mbps @ R859 (Uncapped)10Mbps @ R999(Uncapped)20Mbps @ R1499(Uncapped)2.5Mbps @ R319(Uncapped) Fibre option5Mbps @ R469(Uncapped) Fibre option7.5Mbps @ R589(Uncapped) Fibre option10Mbps @ R699(Uncapped) Fibre optionSpeed in directly affected by signal strength and quality. Recommended speed will be given once installation is done as testing is not accurate enough.Select *Equipment & InstallationCPE (Wireless Radio) + Installation + router @ R1799 once offCPE (Wireless Radio) + Installation + router @ R600 P/M(3 month contract)CPE (Wireless Radio) + Installation + router @ R300 P/M(6 month contract)CPE (Wireless Radio) + Installation + router @ R150 P/M(12 month contract)Choose OneDeclarationDeclaration *Do you accept?I, the undersigned, hereby authorize Netbits (Pty) Ltd to withdraw from my bank account on a regular basis, the amount/s as detailed on my product sign up forms. I have read and understood the Terms and Conditions as specified on www.netbits.co.za. I am aware that monthly charges are 1 month in advance from the date of confirmation. I hereby agree that Netbits (Pty) Ltd shall be entitled to do a credit check on me through ITC or any other recognized institution in order to verify my credit worthiness for contracts. I am aware of the Thirty (30) days calendar notice on cancellation. Except when a 3 to 6 month term is selected above where I will pay the full term.Terms and Conditions *Do you accept?Please see button below to read terms and conditions. SUBMIT APPLICATION TERMS & CONDITIONS ACCEPTABLE USAGE POLICY (AUP) Our Office Mpumalanga South Africa Contact Us info@netbits.co.za +27 83 393 0219 Whatsapp 083 393 0219