Client Details


* Required Information:
First Name + Surname, Email Address, Email Address 2,
Work Telephone, Mobile Number, Company Name, Physical Address
Please tick Read AUP CSA

Referrer

* e.g. Name, Search Engine, Other Website etc   

Title

Mr Mrs Ms Miss The Hon Rev Prof Dr

First Names

Surname

ID / Co Registration no.

VAT Registration Number

Company Name

Physical Address

Work Telephone

Mobile Phone

Home Telephone

Fax Number  

Email Address

Re-enter Email Address

 
 

Select an ADSL Data Bundle (* Minimum Billing)

Data Bundles(Shaped ADSL)

1 GB

2 GB

3 GB

5 GB

10 GB

Monthly Cost


R 59.00


R 114.00


R 162.00


R 245.00


R 440.00

 

Top-Up ADSL Data charged @ R 69.00 per GB

Your account will start off with a minimum balance determined by your average ADSL data usage every month and according to the most suited ADSL Plan chosen .

When your minimum balance runs out, your ADSL account automatically Tops Up by 1 GB at a time up to a limit of X GB.

A limit is set as a protection mechanism against excessive data usage and a high ADSL usage account caused by factors out of your control like some hacking or using your wireless network etc.

Unused Top Up data is carried forward to the following month and never expires.

 

*Minimum Billing: 1 GB, Top Up data - unused Data is carried forward to next month.
* No Contracts, Instant Activation, 30 day cancellation period required.
* Up to 4 ADSL concurrent connections available with DSL Secure Technology.
* DSL user control panel login provided i.e. - check your ADSL usage reports online, anytime.

ADSL Line Rental


ADSL Line Speed

384 Kbits/s

512 Kbits/s

4 - 10 Mbits/s

 


* Monthly Line Rental Cost


R 152.00



R 326.00


R 413.00

 


* Telkom Terms and Conditions apply.
* Line Rental will be charged by 21 Digital Web Solutions, no longer by Telkom.

ADSL Line Installation / Transfer Details

 

Install an ADSL line on an existing landline on Tel No. 

Transfer an existing ADSL line to 21 Digital on Tel No.  *

 

* ADSL Line Transfer Options
 

I wish to keep the same DSL Line Speed of Kbits/s

I wish to upgrade from to Kbits/s

I wish to downgrade from to Kbits/s


* No installation fees! A once off administration fee of R100 incl VAT will apply.

ADSL Modem / Router Options
 

I have my own ADSL Modem / Router

I will purchase my own ADSL Modem / Router from my Computer Supplier or Telkom

I would like to purchase an ADSL Modem / Router from 21 Digital (Pre-configured) POA
 

Method of Payment


Debit Order:


* Service will be suspended if payment is not received by the 7th of the month.

Debit Order prefered method of payment !

Download Debit Order Instruction Form here (PDF)
Fax to 086 610 9112

Terms and Conditions


I have read the Acceptable Use Policy and Customer Service Agreement


* All prices indicated include VAT | E.&.O.E