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Community Champions – Field Sales Agent Form

Community Champions – Field Sales Agent Form

Clients Name(Required)
Enter your clients full name here.
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Confirm your clients address where the clients fibre should be installed.
If the marker is not on the clients rooftop please move the marker by clicking / tapping the map on the clients home.
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Insert your GPS co-ordinates from the map
Select your preferred speed, installation type and ISP.
Enter your primary contact number here.
Clients Email Address(Required)
Please Enter your clients e-mail address here.
Keep me informed of Marketing offers, notifications & product updates.
This field is for validation purposes and should be left unchanged.