EmailMeForm
Application Form - Maxis Business Fibre
Maxis Business Package
*
Please select
Maxis Business 4Mbps (Monthl Fee : RM168, Speed : 4Mbps)
Maxis Business 8Mbps (Monthl Fee : RM208, Speed : 8Mbps)
Maxis Business 16Mbps (Monthl Fee : RM308, Speed : 16Mbps)
Maxis Business 32Mbps (Monthl Fee : RM488, Speed : 32Mbps)
Maxis Business Fixed IP 4Mbps (Monthl Fee : RM188, Speed : 4Mbps)
Maxis Business Fixed IP 8Mbps (Monthl Fee : RM388, Speed : 8Mbps)
Maxis Business Fixed IP 16Mbps (Monthl Fee : RM688, Speed : 16Mbps)
Maxis Business Fixed IP 32Mbps (Monthl Fee : RM988, Speed : 32Mbps)
Applicant Name
*
Company Name
*
Company Registeration Num.
*
IC Number
*
Old IC Number
Contact Number
*
E-mail Address
*
Installation Address
*
City
*
State
*
Poscode
*
Property Type
*
Please select
Landed
High Rise (5 Storey and more)
Preferred Installation Slot
*
Anytime
Weekdays only
Weekend
(For highrise property, please don't choose weekend)
Supporting Document
IC (Front side)
*
IC (Back side)
*
Documents 1
*
Documents 2
*
Documents 3
Enterprise Docs:
1) Borang D
2) Maklumat Perniagaan
3) Maklumat Pemilik masa kini
4) One of the director IC ( front and back )
Sdn Bhd Docs:
1) Form 9
2) Form 24
3) Form 49
4) One of the Director IC ( front and back )
Powered by
EMF
Free Form Builder
Report Abuse
