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WiMax Registration Form Page
Use the form below to fill up your detail, we will get back to you as soon as we can!
For more information about the package, please click here for Wiggy and click here for WiMax.

Package: 
Contract Period: 
Modem: 
MAC Address: 
Serial No: 
APPLICANT INFORMATION
Title: 
Name of Applicant: 
Old IC Number: 
New IC Number: 
Gender: 
Marital Status: 
Office Tel: 
Home Tel: 
Handphone: 
Email address: 
Nationality: 
Race: 
SERVICE ADDRESS
Installation Address: 
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Service Installation: 
Instruction: 
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