SingTel Magix - Sign Up Now

Please complete the information below:
* compulsory fields

*
* First Name:
Given Name:
* NRIC/Passport:

Date of Birth (dd/mm/yyyy) :

Home Address :

House No. / Blk / Tower

Street Name

Floor-Unit No

Condo / Building Name

Postal Code

Contact No:

Home:

Office:

Fax:

Pager:

Mobile Phone:

Email address:

Gender:

Race:

Marital Status:

Housing type:

Occupation:

Hardware Package

- Alcatel ST 510 v4 ADSL modem (external)
- 1 installation CD
- 1 User's Manual
- 1 Micro-Filter
- 1 RJ11 Telephone cable
- 10 BaseT D-Link Ethernet card (PCI)
Note without Ethernet Card : $254.80 (inclusive of GST)

$275.60 (inclusive of GST)

Installation:

* Installation Address
(Where you want your Magix service to be activated, if different from Home Address)

House No. / Blk / Tower		Street Name
Floor-Unit No		Condo / Building Name
Postal Code

* Installation Telephone Number:
(The phone number that your Magix service will be activated on)

We will provide delivery of the hardware to you at no extra charge.

Delivery Address of Hardware: (If different from Installation Address)

House No. / Blk / Tower

Street Name

Floor-Unit No

Condo / Building Name

Postal Code

Subscription Package:

Registration Fee
one-time non-refundable fee is applicable

$30

Please tick one:

$60 for 20 Free hours

$120 for 60 Free hours

* A charge of 5 cents/min block applies after the Free hours.

* Email and User-id
(First character must be an alphabet. Minimum 5 to maximum 8 characters. Lower-case only)

1st Choice:		@magix.com.sg
2nd Choice:		@magix.com.sg
3rd Choice:		@magix.com.sg

Note: SingTel Magix reserves the right to change the chosen ID.

Others

If you need to apply a new telephone line for Magix application, please complete the information below:

Registration Name:
NRIC/Passport:

Billing Address (if different from Home Address)

House No. / Blk / Tower		Street Name
Floor-Unit No		Condo / Building Name
Postal Code

Note: If you are not the applicant for the telephone line, please obtain approval from the registered telephone subscriber for use of Magix service.

Undertakings:

I/We agree to hire the above mentioned service(s) and be bound by the terms and conditions from SingTel as such manner as SingTel deems proper. I/We confirm that the information given herein is true and correct. I/We understand there is a minimum subscription period of 12 months for the hardware.

I/We understand that all charges will be sent to the registered telephone subscriber and will be incorporated in the existing telephone bill. Approval for use of Magix service must be obtained from the registered telephone subscriber.

I/We understand and agree that any outstanding payments incurred with the Singapore Telecom Group of Companies or my PC/Notebook not meeting Magix minimum requirements may delay my application.

Below 18

For applicants below the age of 18 years, approval from parent/guardian is required.

I am the PARENT/GUARDIAN OF THE APPLICANT. I approve his/her application and shall be responsible for his/her undertaking made above. I also agree to be responsible for all outstanding bills incurred during the course of subscription if he/she is unable to do so.

Name:
NRIC/Passport:
Relationship to applicant:

Address :
House No. / Blk / Tower		Street Name
Floor-Unit No		Condo / Building Name
Postal Code

Note:

Prices are subject to 3% GST and change without prior notice. SingTel Magix reserves the right to decline an application without giving any reason and is not obliged to respond to any request from an unsuccessful applicant.