UNIFI

UNIFI REGISTRATION FORM

Fill up all details below and you will be informed shortly.

Business / Personal(Required)

Nationality:(Required)

Application Type:(Required)

Unifi Package:(Required)

Advance Payment : RM 100 - Please be informed Customer have to pay the advance payment within 10 days after installation completed to avoid service interruption

Country:(Required)

New IC No:

Example: 801202106789

Old IC No:

Preferred Login 1:(Required)

Preferred Login 2:(Required)

Preferred Login 3:(Required)

Applicant Name:(Required)

Date Of Birth:(Required)

Contact Person Name:(Required)

Contact Person IC No:(Required)

Phone(Required)

Contact Email:(Required)

Note: Strictly enter only customer's email for billing purposes, Unifi e-bill will be sent to this email address.

Property Type:(Required)

Installation Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Note: Installation address refers to the address where Unifi will be installed.

Preferred Installation Date:(Required)

Preferred Installation Session:(Required)

Remark:

Remark: If customer have specific preferred installation date, please write down in the remark. Example : "Preferred installation date 14/6/2020 Morning" If customer want the installation to be as soon as possible, please write "ASAP" in the remark or leave it blank. We will try to book earliest appointment for customer.

IC Front and Back(Required)

Max. file size: 200 MB.

Digital Copy of Applicant Colour IC (front & back)

Utility Bill(Required)

Max. file size: 200 MB.

Utilities bill (if required). Utilities Bill required if the installation address not the same with the address in IC.