PLEASE NOTE Please complete the online form or alternatively download here and send to admin@futurefibre.co.za Estate and Services Information Select your Estate —Please choose an option—CarmenvillasDe RustEclipseJabulaniMeerenboschOude Westhof MedicalPalm GrovePetrusiaSir QThe KnysnaThe MarineTuinhuis Select Services required 25/25 @ R49950/25 @ R59950/50 @ R699100/50 @ R899100/100 @ R999Silver leave 15/15 R399 ( retirement packages) Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 25/25 @ R49950/25 @ R59950/50 @ R699100/50 @ R899 Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 25/25 @ R49950/25 @ R59950/50 @ R699 Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 25/25 @ R49950/25 @ R59950/50 @ R699 Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 25/25 @ R49950/50 @ R699100/50 @ R899 Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 25/25 @ R49950/50 @ R699100/50 @ R899 Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 25/25 @ R49950/25 @ R59950/50 @ R699Silver leave 15/15 R399 ( retirement packages) Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 25/25 @ R49950/25 @ R59950/50 @ R699Silver leave 15/15 R399 ( retirement packages) Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 25/25 @ R49950/25 @ R59950/50 @ R699Silver leave 15/15 R399 ( retirement packages) Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 25/25 @ R49950/25 @ R59950/50 @ R699100/50 @ R899 Uncapped VoIP @ R229 YesNo Installation Free on 12 month contract, early termination fee will applyMonth to month with R1,499 installation fee Select Services required 20/29 @ R69950/25 @ R89950/50 @ R999100/50 @ R1,150100/100 @ R1,249200/200 @ R1,799 Select Services required 20/29 @ R69950/25 @ R89950/50 @ R999100/50 @ R1,150100/100 @ R1,249200/200 @ R1,799 Uncapped VoIP @ R229 YesNo Subscriber Details First Name / Company Name Surname Contact Number Your Email ID Number Country of Issue Relative or Acquaintance (not residing at the installation address below) First Name Surname Contact Number of above acquaintance Nature of acquaintance "(e.g. friend, partner, parent, etc.)" Installation Address Street Address Street Address Line 2 City Province Postal Code Terms and Conditions Please Note: Bandwidth: The bandwidth provided, if not otherwise spesified, is uncapped and not subject to traffic shaping or throttling Aggregation: No aggregation is permitted. Voice Channels: Voice channels are allowed, and there are no limitations on the number of voice channels available. Installation Fee: The installation fee is a one-time fee that covers the labor involved. However, it does not cover the cost of hardware. Any hardware supplied by Future Fibre remains the property of Future Fibre. Installation Commencement: Installation will begin only after the full payment of the installation fee, if applicable, has been received. Liability for Hardware Damage: The subscriber will be held responsible for any losses incurred by Future Fibre due to direct or indirect damage to the installed hardware. Router Configuration: Future Fibre cannot modify the configuration of the router. If there are specific port or directive requirements, they can be requested. However, such requests may be denied for technical reasons or if they negatively impact network connectivity. Technical Support Callouts: All technical support callouts will be covered by Future Fibre. However, if it is determined that the fault was due to negligence or non-network-related issues, the associated costs will be borne by the subscriber. Account Applications: All applications are for the residence account and not for the owner, unless the owner is also the resident. Service Cancellation: Cancellation of the service requires a 30 business day notice period, that means if the contract is cancelled in any month, you will receive on more invoice for the following month. Contracts: Unless otherwise specified, contracts are for a 12-month duration. Early termination fees may apply. Hardware Ownership: All hardware provided by Future Fibre remains the property of Future Fibre. Service Limitation for Business Use: This subscription agreement is specifically for home internet service. If the service is used for income generation or any other business application, Future Fibre Installations (Pty) Ltd will not be liable for any loss of income resulting directly or indirectly from service interruptions. Downtime Reduction: Future Fibre Installations (Pty) Ltd will make every effort to minimize downtime to the best of its ability. Payments Payment Due Date: EFT payments are to be made before or on the first of each month. Debit Order Options: A Debit Order payment is available through Netcash, a member of the FSB and would reflect “FUTUREFIBR” on your bank statement. Unpaid Accounts: Any account unpaid by the morning of the 5th will be suspended. If accounts remain overdue on the 7th, a R225 reconnection fee will be charged. Failed Debit Orders: Failed debit orders will incur a R65 administration fee and possible resubmission on the 10th. A second failure will result in the client being removed from the debit order list. Service Reconnection: Service will be resumed only after payment reflects in the Future Fibre bank account. Responsibility for Outstanding Debt: The subscriber is responsible for any outstanding debt and the costs incurred in recovering outstanding fees. Installation Payment: Installation will only commence once the full installation fee has been received This subscription agreement is binding upon acceptance of the service subscription agreement with Future Fibre Installations (Pty) Ltd. I have read and agree to all of the terms and conditions. Subscriber Bank Details Payment Method (please indicate) Debit OrderEFT FIRST PAYMENT The first payment to Future Fibre will include: the full installation fee if applicable. the pro-rata subscription billing for the month in which the installation took place. the first full month subscription fee, which is billed in advance. To utilize Future Fibre's debit order system, please authorise Future Fibre by completing the bank details section below. If you prefer to receive a PDF version of the "Authority and Mandate for Payments Instruction: Electronic and Written Mandates" form, kindly get in touch with the accounts department. They will provide you with the necessary form and assist you in completing it accurately. By providing the information, you authorise Future Fibre to initiate debit orders for payment from the provided bank account. Please ensure that the bank details are correct and accurately entered to avoid any issues with the debit order setup. If you have any questions or require further assistance, please contact the accounts department of Future Fibre. They will be able to provide you with the required form and guide you through the process of completing it accurately Debit orders may not be initiated without the relevant mandate. The following will apear on your statement "FUTUREFIBR" Please debit my bank account as shown above, in favour of Future Fibre (Pty) Ltd, with the total amount owing by me. Account Holder First Name Surname Bank Name Branch Name Account Type Account Number Branch Number Declaration Please read and sign this declaration: Activation and billing will commence upon the successful installation. I have selected the indicated product package and understand the service I will be receiving. I declare that the information supplied by me herein, is true and correct. I understand that the conclusion of an agreement with Future Fibre Installations , may be subject to credit vetting. I warrant that I have the contractual capacity and/or are duly authorised to enter into this agreement with Future Fibre Installations ( Pty) Ltd for the above service. First Name Surname Date Enter Your Signature 5 + 6 =