Please tick the appropriate box or complete the answer.

IMPORTANT: Please read the terms and conditions carefully. fill up the details, attach the supporting documents as required and e-mail to application must be made by pr1ma home’s owner or any authorised person (authorisation letter from the home owner is required).

Particulars of Applicant/Subscriber (“Customer”)

Product/Service Details

Type of Product/Service (Package prices are to be advised):

*While we exercise reasonable effort to meet your preferred date, there is no guarantee that we would be able to meet your request
*Voice call rate 0.20 per/min

Billing Information