Frogfoot Application Form Client Details Address Type Banking Details - Select Debit Date -26th of each MonthLast day each the month1st of each Month5th of each Month15th of each Month - Account Type -Cheque AccountSavings AccountTransmision Account DEBIT ORDER TERMS & CONDITIONS I Agree with the Debit Order Terms & Conditions Package Detail - Select Package -Frogfoot Asymetrical 30Mbps / 3 Mbps @ R629.00 p/mFrogfoot Symmetrical 30 / 30 Mbps @ R699.00 p/mFrogfoot Asymetrical 50 / 5 Mbps @ R829.00 p/mFrogfoot Symmetrical 50 / 50 Mbps @ R899.00 p/mFrogfoot Asymetrical 100 / 10 Mbps @ R929.00 p/mFrogfoot Symmetrical 100 / 100 Mbps @ R999.00 p/mFrogfoot Asymetrical 200 / 20 Mbps @ R1149.00 p/mFrogfoot Symmetrical 200 / 200 Mbps @ R1299.00 p/m Installation Options - Select Option -Month-to-Month @ R2000.00 Once-Off Installation & Activation Charger24 Month Contract @ Free Installation & Free Activation You have chosen Month-to-Month The Month-to-Month option, whereby you purchase all the equipment from us. The installation price of R2000.00 includes the following Fibre Router/Fibre Terminal/Fibre Installation up to 30m from Frogfoot Termination point. Should more than 30m be required to install the fibre in your house their will be an addtional charge of R75.00per meter payable to the fibre contractor. MONTH TO MONTH TERMS & CONDITIONS I Agree with the Month to Month Terms & Conditions You have chosen 12 Month Contract The 12-Month-Contract you enter an agreement with us for a 12 Month period, once the period has been completed you will automatically be placed in a Month-To-Month Contract with us. The installation price of R999.00 includes the following Fibre Router/Fibre Terminal/Fibre Installation up to 30m from Frogfoot Termination point. Should more than 30m be required to install the fibre in your house their will be an addtional charge of R75.00per meter payable to the fibre contractor. 12 MONTH CONTRACT TERMS & CONDITIONS I Agree with the 12-Month-Contract Terms & Conditions You have chosen the 24 Month Contract Our 24-Month-Contract includes the following Fibre Router & Fibre Terminal and Fibre Installation up to 30m from Frogfoot Termination point. Should more than 30m be required to install the fibre in your house their will be an addtional charge of R75.00per meter payable to the fibre contractor. 24 MONTH CONTRACT TERMS & CONDITIONS I Agree with the 24 Month Option Terms & Conditions TERMS & CONDITIONS Accept Terms & Conditions Please leave this field empty.