Form Princeton Park Contract Existing Customer

ACCOUNT HOLDER INFORMATION

Select the contract application date on the calendar below (Todays date)

Full name and surname or business name (required)

Full ID number or business registration number (required)

Full VAT number (if applicable)

Contact email address (required)

Alternative contact email address (required)

Contact number (required)

Alternative contact number (required)

ADDRESS INFORMATION

Unit number (if applicable)

Complex name / building name (if applicable)

Street number (required)

Street name (required)

Suburb name (required)

Town name (required)

Postal code (required)

PRODUCT INFORMATION

Please select the product you are applying for from the menu BELOW.

Princeton Park Fixed Wireless Home

Please select the package you are applying for from the menu BELOW.

Fixed Wireless Home 10Mbps - R299 per monthFixed Wireless Home 15Mbps - R399 per monthFixed Wireless Home 20Mbps - R499 per monthFixed Wireless Home 30Mbps - R749 per monthFixed Wireless Home 40Mbps - R999 per month

Please select the contract term you are applying for from the menu BELOW.

Month to month contract (30 days notice for cancellation)

Please click and select the equipment you are applying for from the menu BELOW.

Existing customer, existing equipment installed at premises

WIFI Password (Must be 8 characters or more) (required)

DEBIT ORDER MANDATE

​I accept and agree to this Authority and Mandate which refers to our online signup form as dated upon online acceptance. I hereby authorize Jumbo Technologies to issue and deliver payment instructions to the bank for collection against my above mentioned account at my above mentioned bank (or any other bank or branch to which I may transfer my account) on condition that the sum of such payment instructions will never exceed my obligations as agreed to in the online signup form, and commencing on the commencement date and continuing until this Authority and Mandate is terminated by me by giving you notice in writing of no less than 1 calendar month, and sent by email to accounts@jumbotech.co.za The individual payment instructions so authorized to be issued must be issued and delivered as follows: On the below mentioned day ("Debit order date") of each and every month commencing on the initial payment date as per the invoicing. In the event that the payment day falls on a Saturday, Sunday or recognized South African public holiday, the payment day will automatically be the very next ordinary business day. Further, if there are insufficient funds in the nominated account to meet the obligation, you are entitled to track my account and re-present the instruction for payment as soon as sufficient funds are available in my account. I understand that the withdrawals hereby authorized will be processed through a computerized system provided by the South African Banks and I also understand that details of each withdrawal will be printed on my bank statement. Each transaction will contain a number, which must be included in the said payment instruction and if provided to you should enable you to identify the contract. A payment reference is added to this contract before the issuing of any payment instruction. I shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force, if such amounts were legally owing to you. MANDATE I acknowledge that all payment instructions issued by you shall be treated by my below mentioned bank as if the instructions had been issued by me personally. CANCELLATION I agree that although this Authority and Mandate may be cancelled by me, such cancellation will not cancel the contract. I shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force, if such amounts were legally owing to you. ASSIGNMENT I acknowledge that this Authority and Mandate has been ceded to Netcash (Pty) Ltd as per your agreement with Netcash (Pty) Ltd, but in the absence of such assignment of the online signup form, this Authority and Mandate will be null and void.

I hereby authorize Jumbo Technologies, to debit my account in advance with the total amount payable on my monthly account.

Bank Name (required)

Branch Name (required)

Branch Code (required)

Bank account holder name(required)

Bank account type(required)
SavingsChequeTransmission
Bank account number(required)

Please select a debit order date from the menu below(required)
1st7th16th26th30th
Please attach a copy of the account holder / business director ID document below.(required)

Please attach a copy of your proof of residence below.(required)

I have read and accept the terms and conditions (tick check box)