Pretty Mobile - Electronic Voucher Management & Electronic Voucher Distribution

S ign-up Application
The Real Deal - MTN
(Fields marked with a * are required)



SECTION A: Customer's Details

	Mr. Mrs Miss
First Name:	*
Surname:	*

Physical Address:	*
City / Township:
Postal Code:

Postal Address:
City / Township:
Postal Code:

ID / Passport No.:	*
Home Tel No.:	*
Work Tel No.:
Email Address:



SECTION B: Select Product(s)

1. R55 pm Plan:
	Once-off activation fee of R65. Receive MTN Starter Pack including R50 airtime. Monthly MTN Airtime of R50. Free funeral cover to the value of R3000.
2. R105 pm Plan:
	Once-off activation fee of R115. Receive MTN Starter Pack including R100 airtime. Monthly MTN Airtime of R100. Free funeral cover to the value of R3000.
3. MTN Banking Account for R12:
	Bank account with an ATM card
	Bank account with a Master Card debit card
4. Handset / Cell phone Selection
	Model:
	Price (R):
	Deposit (R):

To complete your submission, you need to download & complete the following form:
Debit Order Form

Please fax your completed form together with a copy of your ID or passport to
088 011 792 3352

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