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Subscriber Details
Title: * First Name: * Surname: *
Cell No: * Tel No: * Fax No: *
E-Mail: *
Username: *
Minimum 6 characters. We recommend basing this on your Company Name as it cannot be changed afterwards.

Company Details
Vodacom Account Number: *
Current Vodacom Sales Person: Other: (enter name)
Company Name: * Registration No: *
Trading As: * Vat No: *
Type of Business: * Public Company (PTY) LTD    CC    Professional Partnership Other
Nature of Business: Trading For: * Years / Months
Holding Company: *
Landlord: Tel No: Premises: Owned Leased
Postal Address: * Delivery Address: *
Town:  * Town:  *
Province:  * Province:  *
Code:  * Code:  *


Authority for debit order / Company details
Please debit my Bank Account as shown below in favour of Vodacom (PTY) (LTD) with the total amount owing by me on the 2nd last working day each month under this agreement.
Account Holders Name: * Bank: *
Branch: * Branch Code: *
Account No: *
No. of years Account open: Current: Transmission  
Please request a Credit Limit:  R  *
Order Number:  *
Authorised Signatory:   * Date:
Title: * First Name: * Surname: *
Cell No: * Tel No: * Fax No: *
E-Mail: *
Designation: *
Any Cancellation of Debit order after activation could result in Vodacom (PTY) (LTD) suspending the service and all cancellation costs will be for the customer's account.

Declaration
Date:  2024-12-21
Should the detail provided by the applicant not be on the Vodacom database, additional documentation will be needed to verify the account.
I have read, understand and agree to these Terms and Conditions. Click here for Terms and Conditions.)

The customer understands that this service carries a Monthly Minimum Charge of 500 SMS (R155 ex VAT @ R0.31 per SMS).

The customer understands that this service is subject to a 2 calendar month cancellation notice period.
YES (you are required to tick this box)