Registration Form


This form may be sent electronically by clicking the "Submit" button below
Alternatively, You can call Heinrich Bohmke directly on 082 820 8600

For prices click here
I would like to register as a subscriber to Up 2 Speed. My details are as follows:

Who should the invoice be made out to:
Email:
Tel No.: Cell No.:
Organisation:(If applicable)
Fax No.:
Address:.

No. of users

How many users :
Subscription type:
 
Tick here and we will contact you to supply a quotation.     

Individual Users Name

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Payment Method:


IMPORTANT: Your subscription to this product needs to be renewed annually. We will send you invoices annually before the expiry of your subscription to remind you unless you instruct us otherwise.