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Telkom Fixed LTE Order Form
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Telkom Fixed LTE Order Form
Order Number
Account Details
First Name
*
Surname
*
Company Name
CK No
VAT #
Address
*
City
*
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*
Phone No
Mobile No
*
Email Address
*
Order Details
Telkom Fixed Lte
*
10GB + 10GB Night @ R199 per month
20GB + 20GB Night @ R299 per month
40GB + 40GB Night @ R399 per month
60GB + 60GB Night @ R499 per month
80GB + 80GB Night @ 599 per month
120GB + 120GB Night @ R799 per month
220GB + 220GB Night @ R1199 per month
Banking Details
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*
Account Number
*
Account Type
*
Cheque
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Account Name
*
Branch Code
*
Customer Declaration
*
I hereby declare that the information provided is true and correct. I give Internet Republic permission to deduct the amount stated on a monthly basis.
Total
1st Month Total: R