EmailMe Form - Unifi Application Form Residential

Type of Application *

Package *

Preferred Service ID *

If more than 1 option please separate with ";"

Full Name (as per NRIC / passport) *

NRIC / Passport No. *

Photostat IC *

Upload your photostat IC front and back (Cross for Unifi Application Only)

Property Type *

Landed

High Rise (5 Storey or more)

Installation Address *

Mobile No. *

Home Tel. No.

Office Tel. No.

Fax No.

Other Contact E-mail *

Confirm

Preferred Communication *

Billing Information *

E-mail (FREE)

Hard Copy Paper Bill (RM8/month)

Billing Address

*

I Agree

I hereby Agree to enclose above particulars to UniFiHSBB.biz for the Unifi Registration Process.