Help the Customer Apply for fibre

Capture the Customers Details

Ensure all information is entered accurately

To know before completing this form.

  • Confirm if the client is the owner of the property.
  • If the client is not the owner obtain proof that the owner has consented to our access to the property to complete the installation.
  • Ensure that the details supplied by the client in this form are the details for the authorised person (person with permission) and that the details captured are the preferred methods to get hold of this client.
  • Please ensure that the client is aware of the Evotel terms and conditions, privacy policy and conde of conduct and where they can find this info.

Evotel – Fibre Application Form – NAC

Test enquiry form for testing passing data through a URL

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MM slash DD slash YYYY
Customers Name & Surname(Required)
Please enter the customers first and last name into the fields above.
Please enter the customers preferred number into the field above, this is the number that will be used to arrange the customers installation.
Customers E-mail(Required)
Enter the customer’s E-mail address, inform the customer that they will be sent a confirmation mail confirming their information.
Enter the clients address in the field above, choose a suggested address or enter the address as follows: Street number, street name, suburb, city, province, area code. separate each with a comma.
Ask the client if they have been previously installed by Evotel, or another ISP, confirm the customers home type, and Identify if the home is free standing or in an MDU or Flat, some installation require additional permissions.
select the right ISP and service provider to serve the customers needs.
Consent(Required)