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Business IT Services

Client Profile Registration Form

Section 1: Personal Info

Please provide your personal and company contact details.

First Name

Last Name

Cell Phone Number

SA ID Number

Company Name

VAT Number

Primary Email Address

Secondary Email Address

Home Phone Number

Work Phone Number

Fax Number

Internet Package Selection

Package Type

Home Fiber / LTE

Business Fiber

Speed / Tier

20 / 10 Mbps – Basic Home

50 / 50 Mbps – Standard Home / Small Office

100 / 100 Mbps – Pro / Fast Business

200+ Mbps – Enterprise / Heavy User

Installation Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Section 3: Invoicing

Configure your billing preferences.

Accounts / Billing Email Address

Preferred Billing Currency

Billing Contact Person

Section 2: Control Panel

Set up your secure access credentials.

Password

Confirm Password

Section 4: Notification Settings

Choose the type of communications you would like to receive.

Email Notification Preferences

Invoices & Receipts

Technical Support & Tickets

Service Updates

Marketing & Newsletters

60 Jim Fouchè Street, Universitas, Bloemfontein 9301

igno@ivrit.co.za
tech@ivrit.co.za

051 001 0003
084 445 2397