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Meeting Center Application

SERVICE REGISTRATION FORM

Audio With Data

Please complete the web form and click Submit.
For more information, please call (+6) 03-2240 4777 or Freephone 1 800 88 1055

* are required fileds

SECTION I : CUSTOMER DETAILS

Name of Company * :

*

Business Registration No. * :

*

Department * :

*

Company's Address * :

*

Contact Person * :

*

Designation * :

*

Tel * :

*

Fax * :

*

E-mail * :

*

SECTION II : BILLING DETAILS

You will be assigned an Audio With Data Meeting Number under your existing fixed line telephone account issued by TM. Charges will be billed to this Service Number. Please state the fixed line Telephone Number through which account you wish your Audio With Data charges to be billed to * :

Fixed Line Telephone Service Number * :

*

SECTION III : AUTHORIZED USERS

Please list the names of personnel authorised to utilise Audio With Data in the future.

Personnel 1 :

Name :

*

Designation :

*

I/C No :

*

Contact Tel. :

*

E-mail :

*

Personnel 2 :

Name :

*

Designation :

*

I/C No :

*

Contact Tel. :

*

E-mail :

*

Personnel 3 :

Name :

*

Designation :

*

I/C No :

*

Contact Tel. :

*

E-mail :

*