UNIFI home FIBRE BROADBAND
APPLICATION FORM

Select Your Plan

Select Package

Select Plan

Preferred Installation Date

Full Name (as per MyKad/Passport)

Phone Number

+60

Email Address

Identity Card / Passport Number

Attach Applicant IC / Passport / Visa

FRONT SIDEChoose File

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BACK SIDEChoose File

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Attach water bill / electric bill / tenancy agreement

SUPPORTING DOCChoose File

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Supports JPG / PNG / PDF, maximum 5MB per file

Address Line 1

Address Line 2 (Optional)

City / State

Postcode

Existing User?

I have read, understood and agree to be bound by the Terms & Conditions accompanying the subscription of the product(s) and/or service(s).

Safe & Secure Application • No Hidden Charges

Official Distributor

Verified Process

Standard Contract

Nationwide Coverage