COLLECT MY MODEM IMPORTANT NOTE: This is not a service application form, and therefore is not binding in any way. Customer and Service Details Customer Name (required) Email Address (required) Account Number (required) Mobile Contact Number (required) Please enter the best mobile number for collection updates. Modem Collection Details Preferred Customer Care & Retail Centre (required) — Select Pickup Location —Ganilau HouseGarden CityNausori Plaza Preferred Pickup Date (required) Please select the date you intend to collect your modem. Collection Notes or Remarks (required)
