Subscription Form | Infin8green

Online Application Form

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Company Name/ CC Name/ Trust Name

Phone

Complex Name/ Street Name

Last name

ID Number/ Company Registration Number

Block & Unit Number

Address

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Acknowledge Commitment Period
Month-to-month Subscription (Commitment period of 3 Months)

I Acknowledge

Once-Off Line Activation Fee
Once-Off Line Activation Fee (Including VAT) - R599.00

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Details of person available for Scheduled install

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EFT

Debit Order

Debit Order Details
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Account Holder Name

Branch Code

Account Type

Bank Name

Account Number

I hereby authorise Infin8green Trading (Pty) Ltd to debit my account with the total amount payable on my monthly account.

I have read, understood and agree to the Terms and Conditions that accompany this application form, and declare that the information given is true and correct. I have read, understand and agree to the terms and conditions at www.infin8green.com. (Please ensure you have read and understood our T&C’s)

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