Change of service request form

1Customer Details > 2Fibre / Braodband > 3Service Details > 4Equipment Details > 5Confirm Service Order > 6Review Your Entry
Customer ID *
Must be 6 characters. Currently Entered: 0 characters.
Please contact your sales representative or account manager if you do not know your customer id.
Your Company name *
Your name * First Last
Your email *

A copy of this form will be sent to the email address provided here.
Your Contact number *
Please select one of the following: *

Please select one of the following: I am a Satellite Customer I am a Fibre / Broadband Customer I am a Private Network Customer
Private Network Name
What would you like to do? *

Please use one form per service request.
Please select one of the following *

Please use one form per service request.
Service/Site ID *
Effective date * / DD / MM YYYY

The effective date is the date when the action is executed. If you would like to have it done at the end of your billing cycle please select that date as the effective date.
If you select a date prior the end of your service billing cycle the action will be performed on that day, but the billing cycle will continue towards its end.
IDU Serial Number