Unifi Home Package Form

PACKAGE NAME

UNIFI HOME 100MBPS @ RM129UNIFI HOME 100MBPS @ RM189 (UNIFI PLUS BOX)UNIFI HOME 300MBPS @ RM199 (UNIFI PLUS BOX)UNIFI HOME 30MBPS @ RM149 (UNIFI PLUS BOX)UNIFI HOME 30MBPS @ RM89">UNIFI HOME 30MBPS @ RM89UNIFI HOME 500MBPS @ RM249 (UNIFI PLUS BOX)UNIFI HOME 800MBPS @ RM349 (UNIFI PLUS BOX)(M2U EXCLUSIVE PROMO) UNIFI HOME 30MBPS @ RM129 (UNIFI PLUS BOX)(M2U EXCLUSIVE PROMO) UNIFI HOME 30MBPS @ RM69(WINBACK) UNIFI HOME 100MBPS @ RM129(WINBACK) UNIFI HOME 100MBPS @ RM189 (UNIFI PLUS BOX)(WINBACK) UNIFI HOME 300MBPS @ RM199 (UNIFI PLUS BOX)(WINBACK) UNIFI HOME 30MBPS @ RM149 (UNIFI PLUS BOX)(WINBACK) UNIFI HOME 30MBPS @ RM89(WINBACK) UNIFI HOME 500MBPS @ RM249 (UNIFI PLUS BOX)(WINBACK) UNIFI HOME 800MBPS @ RM349 (UNIFI PLUS BOX)

APPLICATION TYPE

NEWMIGRATEEXCLUSIVE BUILDINGEASY SWITCHOUTLET

CUSTOMER NAME

NRIC / PASSPORT NO

NATIONALITY

MALAYSIANNON-MALAYSIAN

DATE OF BIRTH

GENDER

MALEFEMALE

INSTALLATION ADDRES

STATE

CONTACT NO

ALTERNATE CONTACT NO

EMAIL ADDRESS

PREFERRED INSTALLATION DATE

IC FRONT

IC BACK

UTILITY BILLS (ELECTRIC OR WATER)

OTHERS (OPTIONAL)