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                Registration

 

 
 
 
                                           Download fax registration form here
The below form is not  compatible Firefox

Please note that you are registering as a Vox Dealer and that there is a
R780 membership fee to become a dealer. Thereafter R150 / annum.
 
Please complete the following to register
 
I am a:
 
   
Title:
First Name:
Last Name:
ID/Passport Number:
Please supply at least one contact telephone number:
Tel:
Cell:
Email:
Confirm Email:
Please create a login password:
Confirm password:
NB: Remember your password! You can use your email and password to login to your account.
 
 
 
Delivery Address
 
Address 1:  
Address 2:
Suburb:  
City:  
Postal Code:  
Province:  

 

 
 
 
Account Type:
 
Bank:
 
Branch Name:
 
Branch Number:
 
Account Holder:
Account Number:
 
Your monthly annuity usage and rental billing is payable by debit order only.

YOUR ACCOUNT WILL BE DEBITED WITH R 780.00
 
I agree that I have read the Terms and Conditions and that all my info is correct and hereby grant Vox Telecom Pty Ltd authority to debit my / our account with amounts payable by me / us.
 
How would you like to pay for online purchases?
 
 


  

 
The above form is only compatible with Internet Explorer.  Not Firefox  
Download fax registration form if you struggle
   
   
     
 
 

 
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