Sign up for Basic Solutions Please enable JavaScript in your browser to complete this form.Company Name(Only if applicable)Company VAT number(Only if applicable) Code Information ID Company reg number(Only if applicable)Personal Information *FirstLast(Please enter your valid Name and Surname)ID Number *(Please enter your valid South African ID number)Phone number *(Please enter a Valid Phone number)Email *EmailConfirm Email(Please enter a valid Email address)Address InformationProvince *— Select Choice —Eastern CapeFree StateGautengKwaZulu-NatalLimpopoMpumalangaNorth WestNorthern CapeWestern Cape(Please select the Province you reside in)City/Town *(Please enter the City/Town you reside in)Postal Code *(Please enter your valid Postal Code)Residential Type *— Select Choice —OwnedRentedLandlord nameFirstLast(If applicaable)Landlord Contact number(If applicable)Package *— Select Choice —Basic Solution 2 Mbps up to 8 Mbps@ R323.00Basic Solution 4 Mbps up to 10 Mbps @R556.00Basic Solution 6 Mbps up to 15 Mbps @R758.00Basic Solution 8 Mbps up to 20 Mbps @R818.00Basic Solution 10 Mbps up to 25 Mbps @R919.00Basic Solution 15 Mbps up to 30 Mbps @R1 515.00Basic Solution 20 Mbps up to 35 Mbps @R1 515.00Basic Solution 30 Mbps up to 40 Mbps @R2 550.00Basic Solution 40 Mbps up to 50 Mbps @R3 200.00Basic Solution 50 Mbps up to 60 Mbps @R3 750.00(Please select the package you want)Installation Option *— Select Choice —12 Month Contract @ R4 030.00 One Time hardware Cost | or +R671.66 over 6 month | or +R335.83 over 12 months24 Month Contract @ R2 420.00 One Time hardware Cost | or +R403.33 over 6 months | or +R201.66 over 12 monthsOwn Equipment (If compatible) @R400.00 p/h One Time Reinstallation costs(Please select the Installation Option you want)Promo Code(Please enter a valid promo code if applicable)Who Helped you with the solution? *— Select Choice —ChristiaanDavidElsieJacquesRichelleSamanthaI just stumbled onto the website…(Please select the person who assisted you)Payment Option *— Select Choice —CashEFTDebit Order(Please select the method you want to use for payments)Terms & Conditions *I have read and I accept Neofibre’s Terms & Conditions(This is required before we can further assist you)Submit