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Complete this page to generate an application form in order that your company can gain access to our system and make use our services.  After reciept of your completed application form and the approval process, you will be notified via email which will include a username and password and connection parameters.

Individuals and interactive users of SMS can register directly via Web2SMS for credit card payments.
 
Once your application form has been completed, please send the signed copy
via FAX to +27 21 686 7023 or via EMAIL to
 
Company Name 
Telephone No 
Facsimile No 

Postal Address
Country 
Post Code

 

Financial Contact Name 
Financial Contact Cell No 
Financial Contact Email

 

Technical Contact Name 
Technical Contact Cell No 
Technical Contact Email

 

The graphical verification code displayed below is used to prevent automated registrations by software programs. You can hold your mouse over each of the six graphics for a few seconds to confirm the characters.
Verification Code UZQCT
Enter Verification from Above 
 
 
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