JV for EBU (Internal)

Agent info

Agent type {{errorMessages.agentType.required}} {{errorMessages.agentType.pattern}}

PERID {{errorMessages.INPER.required}} {{errorMessages.INPER.pattern}} {{errorMessages.INPER.pattern}} {{errorMessages.INPER.pattern}} {{errorMessages.INPER}} {{errorMessages.INPER.pattern}}

SFID {{errorMessages.SFID.required}} {{errorMessages.SFID.pattern}} {{errorMessages.SFID.pattern}} {{errorMessages.SFID.pattern}} {{errorMessages.SFID}} {{errorMessages.SFID.pattern}}

Your company data

Customer number It can be found on the left corner of your last bill or payment statement, next to the document number {{errorMessages.customerId.required}} {{errorMessages.customerId.pattern}} {{errorMessages.customerId.pattern}} {{errorMessages.customerId.pattern}} {{errorMessages.customerId}} {{errorMessages.customerId.pattern}}

Address for fiber installation

{{errorMessages.lomKey}} The field is mandatory

Primary contact person

Language {{errorMessages.CONTLANG2.required}} {{errorMessages.CONTLANG2.pattern}}

Title {{errorMessages.TITLE2.required}} {{errorMessages.TITLE2.pattern}}

First name {{errorMessages.FNAME2.required}} {{errorMessages.FNAME2.pattern}} {{errorMessages.FNAME2.pattern}} {{errorMessages.FNAME2.pattern}} {{errorMessages.FNAME2}} {{errorMessages.FNAME2.pattern}}

Last name {{errorMessages.LNAME2.required}} {{errorMessages.LNAME2.pattern}} {{errorMessages.LNAME2.pattern}} {{errorMessages.LNAME2.pattern}} {{errorMessages.LNAME2}} {{errorMessages.LNAME2.pattern}}

Prefix {{errorMessages.CONTCB2Country.required}} {{errorMessages.CONTCB2Country}}

Phone number {{errorMessages.CONTCB2Phone.required}} {{errorMessages.CONTCB2Phone.pattern}} {{errorMessages.CONTCB2Phone.pattern}} {{errorMessages.CONTCB2Phone.pattern}} {{errorMessages.CONTCB2Phone}} {{errorMessages.CONTCB2Phone.pattern}}

E-mail {{errorMessages.CONTEMAIL2.required}} {{errorMessages.CONTEMAIL2.pattern}} Please match the e-mail address above {{errorMessages.CONTEMAIL2.pattern}} {{errorMessages.CONTEMAIL2.pattern}} {{errorMessages.CONTEMAIL2}} {{errorMessages.CONTEMAIL2.pattern}}

On-site technical contact

Do you want to specify a distinct technical contact? {{errorMessages.isTechnicalContactDifferentThanDecision.required}} {{errorMessages.isTechnicalContactDifferentThanDecision.pattern}}

Language {{errorMessages.CONTLANG.required}} {{errorMessages.CONTLANG.pattern}}

Title {{errorMessages.TITLE.required}} {{errorMessages.TITLE.pattern}}

First name {{errorMessages.FNAME.required}} {{errorMessages.FNAME.pattern}} {{errorMessages.FNAME.pattern}} {{errorMessages.FNAME.pattern}} {{errorMessages.FNAME}} {{errorMessages.FNAME.pattern}}

Last name {{errorMessages.LNAME.required}} {{errorMessages.LNAME.pattern}} {{errorMessages.LNAME.pattern}} {{errorMessages.LNAME.pattern}} {{errorMessages.LNAME}} {{errorMessages.LNAME.pattern}}

Prefix {{errorMessages.CONTCBCountry.required}} {{errorMessages.CONTCBCountry}}

Phone number {{errorMessages.CONTCBPhone.required}} {{errorMessages.CONTCBPhone.pattern}} {{errorMessages.CONTCBPhone.pattern}} {{errorMessages.CONTCBPhone.pattern}} {{errorMessages.CONTCBPhone}} {{errorMessages.CONTCBPhone.pattern}}

E-mail {{errorMessages.CONTEMAIL.required}} {{errorMessages.CONTEMAIL.pattern}} Please match the e-mail address above {{errorMessages.CONTEMAIL.pattern}} {{errorMessages.CONTEMAIL.pattern}} {{errorMessages.CONTEMAIL}} {{errorMessages.CONTEMAIL.pattern}}

This information will only be used to make the appointment for the fiber installation.

By submitting this form, you confirm that you have received the customer's explicit request to initiate this fiber connection order on their behalf. You have also informed the customer that the technical contact's information will be shared with Fiberklaar, the network builder. This information is necessary to facilitate the initial installation of fiber.

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Fiber request form

Agent info

Your company data

Address for fiber installation

Primary contact person

On-site technical contact

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Fiber request form

Agent info

Your company data

Address for fiber installation

Primary contact person

On-site technical contact

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