SMI SDU Form - Evotel

Evotel – SMI SDU Form

Fill in the form below to show your interest in getting fibre once the area goes live! Need some more information before you commit?

Agent Name

Please select your name from the dropdown.

Clients Name(Required)

First Last

Enter your clients full name here.

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Geocoder

Use this button when you are at your clients installation address

Clients Installation address(Required)

Confirm your clients address where the clients fibre should be installed.

Ensure marker is on your clients Rooftop (installation address)

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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GPS co-ordinates(Required)

Insert your GPS co-ordinates from the map

Clients Cell Phone Number(Required)

Enter your primary contact number here.

Clients Alternative Phone number

Clients Email Address

Enter Email Confirm Email

Please Enter your clients e-mail address here.

Select Your Clients Prefered Fibre Line Speed(Required)

10/2Mbps – From R549/m

30/30Mbps – From R719/m

75/75Mbps – From R869/m

125/125Mbps – From R1009/m

300/300Mbps – From R1149/m

850/850Mbps – From R1289/m

Write additional notes here.

Please contact me when my area goes live to assist me with my Fibre installation.

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This field is for validation purposes and should be left unchanged.