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Payment & Debit Order

Debit order details for monthly billing

Bank Details

If the debit date falls on a weekend or public holiday, the debit order will run the next business day.

Debit Order Mandate

Please review and accept the debit order authority below

AUTHORITY AND MANDATE: ELECTRONIC
DebiCheck / Netcash

A. AUTHORITY / MANDATE

Given by (Account Holder):
Address:
Bank Name:
Branch Number:
Account Number:
Type of Account:
Amount:
Debit Date:
Contract Reference:Assigned on submission

B. MANDATE

C. CANCELLATION

D. ASSIGNMENT

Document Upload

Upload your supporting documents for verification

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JPG, PNG, PDF • Max 10MB

Drag & drop or click to browse
JPG, PNG, PDF • Max 10MB

Drag & drop or click to browse
JPG, PNG, PDF • Max 10MB

Sign & Submit

Sign and accept to complete your application

Digital Signature

By signing below, you authorise both the Service Agreement and Debit Order Mandate


Terms & Conditions

• All pricing is VAT inclusive. Prices are subject to change without notice.

• Pro rata and once-off activation fees must be paid no more than 7 days after the invoice date.

• Any cancellation must be submitted in writing to Sales@waspglobal.co.za

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