Adsl line signup – Blue Chip Computers

Adsl Line rental

Adsl Line rental only

Name

First Last

Phone Number

Email address

ID/Passport No:

Physical Address

Street Address

Address 2

City State / Province

Postal / Zip Code Country

Package Required

I have read and understand the terms & conditions. When you submit this form, you are entering into a legal purchase agreement. Do you agree?

Yes, I agree

Terms & Conditions

Please email the following documents:
1) Copy of ID
2) Proof of residence
3) 1st page of telkom bill (if not used as proof of residence)
4) Contact Details
5) Banking details (debit order)
to sales@bluechipcomputers.co.za