TIME Home New Application

TIME Home New Package Information

Package (required)

—Please choose an option—TIME Fibre Home Broadband100Mbps@RM149300Mbps@RM189500Mbps@RM229

Customer Name (required)

NRIC or Passport No (required)

Office Contact

Mobile Contact (required)

Email Address (required)

Alternatif Contact Person Name

Alternatif Contact Person Mobile No

TIME Home New Installation Address

Address (required)

City (required)

State (required)

—Please choose an option—JohorKedahKelantanMelakaNegeri SembilanPahangPerakPulau PinangPerlisSabahSarawakSelangorTerengganuWilayah Persekutuan KLWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaOthers

Postcode (required)

TIME Home New Billing AddressSame as Installation Address

Address

City

State

—Please choose an option—JohorKedahKelantanMelakaNegeri SembilanPahangPerakPulau PinangPerlisSabahSarawakSelangorTerengganuWilayah Persekutuan KLWilayah Persekutuan LabuanWilayah Persekutuan PutrajayaOthers

Postcode

Additional Information

Login ID (20 chars)

Dealer Remarks

Supporting Documents (Max 1mb gif png jpg jpeg)(Void for Time use)

NRIC Front or Passport (required)

NRIC Back

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