FibreSpeed - Customer Enquiry Form
FibreSpeed - Customer Enquiry Form
Name(s)
*
Surname(s)
*
Email
*
NIE Nº.
*
Address
*
Post Code
*
Telephone/Mobile Number
*
Permanent Resident?
Permanent Resident?
YES
NO
PACKAGE DETAILS
Select Line Speed Required
NOTE: If you stream IPTV you will also need to buy & use a SWITCH
*
Select Line Speed Required
NOTE: If you stream IPTV you will also need to buy & use a SWITCH
WaveFibre - 40
WaveFibre - 70
WaveFibre - 100
WaveFibre - 150
Select Type of Contract Required
*
Select Type of Contract Required
24 mth permanency
12 mth permanency
No Fixed Permanency
PAYG (Pay As You Go)
Select Router Required
*
Select Router Required
Standard Router @ 0€ per month
DECO MESH Dual Band @ +2€ per month
Comments - Let us know if you have any special requirements.
Preferred Monthly Payment Method
*
Preferred Monthly Payment Method
Cash
Credit/Debit Card
Direct Debit
Bank Transfer
Preferred time for installation.
*
Preferred time for installation.
09:00-12:00 - Mornings
12:01-17:00 - Afternoons
Any time
Preferred Installation Date
Preferred Installation Date
/
MM
/
DD
YYYY
Data Protection / Protección de Datos
*
Data Protection / Protección de Datos
I agree to the sending and retention of this personal data for Tenerife Insurance Services SL as exclusive collaorators with FibreSpeed SL in compliance with The Data Protection Act. / Estoy de acuerdo con el envío y retención de estos datos personales para Tenerife Insurance Services SL como colaborador exclusivo con FibreSpeed SL en cumplimiento de la Ley de Protección de Datos.
Type the letters you see in the image below.