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New Account Details
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Name
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User ID/Login ID (NOT RSA ID No)
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Password
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Confirm Password
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Contact Details
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Contact Person
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Telephone Home
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Telephone Work
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Telephone Fax
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Telephone Mobile
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Email Address
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City
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Country
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Physical Address
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Line 1
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Line 2
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Line 3
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Postal Code
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Postal Address
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Line 1
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Line 2
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Line 3
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Postal Code
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Banking Details
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Bank
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Branch
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Branch Code
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Account Number
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Account Type
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Account Holder
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VAT Number
(If you do not have a VAT number, leave this field blank
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Connection Details
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IP Address
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38.107.179.221 |
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Host Name
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38.107.179.221 |
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Date
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2012-01-28 13:51:44 |
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Once you click on the register button, an email will be sent to the address you provided above.
To activate your account, follow the instructions in the email.
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I have read and agree to the terms and conditions listed here.
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Yes, I agree to be billed R100.00 every month for the use of this service.
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