Telephone Line :

-- Sila Pilih --
Kediaman
Kediaman (Prepaid)
Perniagaan

Package

-- Sila Pilih --
Kediaman + Voice 28
Kediaman + Voice 48
Kediaman + Voice 68
Perniagaan - RM45
Perniagaan - SME ONE PLAN 68
Perniagaan - SME ONE PLAN 78

Applicant Name :

Company Name :

NRIC(New) :

NRIC(Old) :

BR Number :

Address :

Enhanced Facilities

Speed Dialing
Call Transfer
Call Transfer on Busy
Call Transfer on No Reply
Caller Line Identification
SMS
Call Waiting
Reminder Call

Reference No (Neighbour's number) Please be reminded that the above Reference No. that is being input, is a Service Number that exist and nearest to the applicant Installation Address To Quick Installation:

Contact Person Name :

Contact Person IC No :

Contact No :

Dengan ini, saya mengesahakan bahawa butir-butir diri saya diatas adalah benar. Jika ada maklumat salah, kami berhak untuk tidak memproses permohonan anda. ** Sila Hantar Salinan IC ke email tumpatown@yahoo.com

Agent ID [For Agent Use Only]