Maxis Business New Application


Maxis Business New Application

Maxis business new application packages promotion, check coverage, online application.

A. Maxis Business New Individual

Title (required)
Mr.Ms.Others (Please specify)

Name of Company (required)

Business Reg No (required)

Authorised Officer (required)

Gender
MaleFemale

NRIC or Passport No (required)

Date of Birth (required)(e.g. 04/14/1944)

Contact No

Mobile No (required)

Alternative Contact No

Nationality
MalaysianNon-Malaysian

Race
MalayChineseIndianOthers

Email (required)

B. Maxis Business New Installation Address

Hse/Apt/Lot/Unit No (required)

Floor No

Block Name

Building/Apt Name

Street No/Name (required)

Garden/Section

City

Postcode (required)

State

Country

Preferred Installation Date (e.g. 04/14/1944)(Installation is typically conducted between 2-4 weeks after you register for the Service. Should you require the installation to be done after 4 weeks, please select your preferred date)

C. Maxis Business New Billing AddressSame as Installation Address

Address

City

State

Postcode

Additional Note

D. Service Packages

Package (required)

Dealer Remarks

E. Supporting Documents (Max 1mb gif png jpg jpeg)(Void for Maxis use)

NRIC Front or Passport (required)

NRIC Back

Business Reg Doc (required)

Check here if you accept these terms and conditions.

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