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Astro Maxis IPTV Application
Avoid queuing and waiting at the sales counter. We are the authorized dealer that can help you to handle your application from the beginning to the end. Enjoy the latest promotion as advertised. You are naturally entitled to the promotions occurring at the time of your application.
NAME
*
Name as per NRIC or Passport
NRIC / PASSPORT NO
*
NRIC or Passport NUMBER
CONTACT NO
*
Installer call for installation
EMAIL
*
HOUSE/LOT/UNIT NO
*
Eg. CONDO/APARTMENT: BLOCK - FLOOR - UNIT NO
BLOCK/BUILDING NAME
Eg. Arena Green Condo
STREET NAME/AREA/
POSCODE/STATE
*
Eg. Jln Mewah, Taman Desa, Shah Alam, 56000, Kuala Lumpur
TYPE OF DWELLING
*
CONDO / APARTMENT
FLAT
BUNGALOW
SEMI-D
TERRACE HOUSE
HOSTEL/BARRACK/STAFF QUARTER
EXISTING MAXIS FIBRE CUSTOMER
NO
YES - MAXIS
Kindly provide account no as below if "YES"
EXISTING MAXIS FIBRE ACCOUNT NO (IF ANY)
EXISTING ASTRO CUSTOMER
NO
YES - UNDER CONTRACT
YES - EXPIRED CONTRACT
Kindly provide account no as below if "YES"
EXISTING ASTRO ACCOUNT NO (IF ANY)
Astro Package
*
Please Select
Super Pack 1 (RM133)
Super Pack 2 (RM133)
Super Pack 3 (RM155)
Super Pack 4(RM133)
I want to Subscribe for Maxis Fibre Only
Astro IPTV Package
Copy & Paste into your browser to view
Astro Super Pack Package
Copy & Paste into your browser to view
Fiber Package
*
Please Select
Maxis Fiber 10MB (RM148)
Maxis Fiber 20MB (RM198)
Maxis Fiber 30MB (RM248)
I want to subscribe Astro Only
Mini Package
*
News
Learning
Kids
Variety
None (Maxis Fibre Subscriber Only)
Super Pack Customer Entitled 3 Minis Package for FREE. Please tick 3 only.
Remark
Preferred Method Of Payment
Please Select
Visa
MasterCard
Amex
Diners
Cash
Note:
1. For Astro IPTV customer only
2. RM300 activation fee will be waived if payment made by auto debit or 6 months advanced payment throughout the contract period.
3. Only local Credit/Debit/Charge card is accepted.
4. If you do not wish to disclose your Credit Card details here, please select "CASH" and you may may call Astro B.yond IPTV hotline at 03 9543 1543 or walk in to any Astro Customer Service Centre to apply for auto debit or update your credit card details 14 days after registration. The activation fee of RM300 will be charged on your first month’s bill. However, customer will obtain a rebate for the activation fee if customer apply for auto debit within 3 months after activation of the service.
Billing Frequency
Please select
Monthly
Quarterly
Half Yearly
Yearly
Credit Card Number
Notes:
1. For Astro IPTV Customer Only
2. No need to fill if you only subscribe for Maxis Fibre
Card Expired
Month / Year
Issuing Bank
Upload Credit Card
Front & Back Credit Card
Cross For Astro & Maxis Use Only
Upload NRIC /Passport
*
Front & Back NRIC / Front Page of Passport
Cross For Astro & Maxis Use Only
Preferred Installation Date
*
MM
/
DD
/
YYYY
HH
:
MM
AM
PM
AM/PM
Please stated time and date for us to arrange installation
Terms and Conditions
For new subcriber of Astro Maxis IPTV :
1. The account must remain active for a minimum of 24 month
2. RM300 standard installation fees.
3. Installation fees will be waived if applicant use Auto Debit or 6 months advance payment
*
YES
NO
**Please do not hesitate to drop us email at astro@arista.my if you need further clarification.**
Office Use Only
Sales ID
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