Application form The Applicant FormFirst NameLast NameIdentification type National ID Travel PassportID or Passport NumberSpecial GVS customer account number (GVxxxx/yy)Email address of applicantTelephone number of applicantApplicant’s Residential / Business EstateProposed Wi-Fi Location Building or Apartment NameApartment number/ Building Number/Plot numberEmergency Contact two namesEmergency contact telephone numberApplicant’s Postal AddressAddress Line 1CityWhich of the following best describes your application type? Single individual use applicant Host user applicant Host non-user applicant Base substation applicantOur hosts enjoy the following company privileges. Which one of the privileges will you wish to select as a host? Select all that apply: Discount of 25% on main package cost Free default package of 3mbps once the host has a minimum of four users connected to his/her access point. Installment payment privileges for the router to be completed within 4 months of connection I am not interestedHow many people will be using the internet from the access point? (A) 1 to 3 (Few users’ access) (B) 4 to 6 (More users’ access) (C) 7 to 9 (Several users’ access) (D) Unlimited multiple users’ accessYou will use the internet as follows: (Select ALL that applies to you) Emails or browsing or research on computer but no downloading Smart phone use for emails or calls You tube and I have one Television for YouTube or media streaming Frequent video conferencing for job or onine classes You tube and I have more than one Television for YouTube or media streaming I do daily downoads for research, training or job related activities. I work from home and my job demands continuous unlimited online presence I have a business where my customers must be online as the nature of activities eg students Any other usage situation: Explain belowExplain any other usage situation not listed aboveDid your customer care agent explain all the Package options, conditions and terms before you made an informed decision? Yes NoSelect only one package that you have chosen to subscribe for internet access with Glovynet Virtual Interlinks Ltd: (A connection expert will advise you depending on your usage situation) GSB859: Group Sponsored Basic Access GSP812: Group Sponsored Premium Access IBW816: Individual Basic Access IPW815: Individual Premium Access ISP796: Individual Super Premium CPA798: Corporate Premium Access BCC809: Business and Customized OptionsHow soon do yo wish to be connected? Immediately Within a week Within a month Not sure I will callHow did you hear about our services? (Select all that apply) From Neighbor From Company staff A friend referral Advertisement event Circulated flyer Search engine Any otherHave you ever used Wi-Fi before? Yes NoWho is our company contact person that talked to you about our services?Did you understand that you need cable and router for private access and a receiver before you get online? Yes No I don’t knowChoose one option you have decided to use for obtaining the signal receiver device: I will buy my own I already have my own I will hire purchase and pay installments for my own For now, I will rent for use I will contribute we buy a group receiver deviceBuying cable and router are mandatory options for you to acquire before you proceed with the contract. Are you informed about this? Yes No I don’t knowDo you understand that its your full responsibility to maintain full security for all internal and external internet devices and protect them against vandalism and theft as best as you can possibly do? Yes NoDo you understand what you are paying for before connection? Select all that apply to you: Monthly standard package subscription Cable for connection Private router Own signal receiver device Rental signal receiver deviceDo you understand your regular monthly payments? Please select what applies to you: Monthly standard package subscription Equipment rental charges Equipment installment charges for hire purchaseA reconnection fee of 5% of package fee or Ksh. 200 (Two hundred), whichever is higher will be charged with no exception for any delayed payment beyond the offered grace period regardless of the reason, excused or unexcused. Do you understand this clause in the service agreement? Yes No I don’t knowPayment via website is mandatory. Did your Company agent train you how to pay online via our website? Yes NoSubmitting payment confirmation is mandatory. Did your company agent show you how to submit payment confirmation via Contact form? Yes NoDid you understand the content of the contract and service charter as explained? Yes No I don’t knowOUR SERVICE CHARTER AND PROCESSES>>>>> STEP 1: The Client develops interest in our internet services.>>>>> Immediately to STEP 2: The Company representative/ recruiter explains services, terms and details about all packages we offer.>>>>> Within one hour to STEP 3: The company technician visits the intended area of connection for assessment of signal and determination of what is required for efficient reliable connection.>>>>> Immediately to STEP 4: The technician lists all requirements and discusses each item with the client as well as options available as per requirements. He takes time to understand the client needs and handles all concerns as a networking professional. He updates the client representative for action in the subsequent steps.>>>>> Within one hour to STEP 5: Another company representative calls the client to confirm that the client understood all our terms for service and knows all requirements and obligations.>>>>> Immediately to STEP 6: If the client confirms understanding of requirements, terms and conditions and feels ready to proceed, he/she will meet with the assigned representative to discuss final steps and get a demonstration of our service platform about reporting problems and concerns, accessing products and payment procedures.>>>>> Within one hour to STEP 7: The client informs the representative when he/she will be ready with mandatory requirements and payment. At this point, a special account is created, and the client completes an online application form using the special account number.>>>>> Maximum 24 hours to STEP 8: The client makes payment, payment is verified, the technician and the networking team proceeds to install devices and connect the client to our network and Wi-Fi signal within one hour after payment and confirmation of mandatory requirements.>>>>> Immediately to STEP 9: The client representative will call him/her once a week or more frequently to find out if there are any problems to be solved to prevent interruptions.>>>>> Ongoing to STEP 10: Client is advised to communicate IMMEDIATELY even about the slightest problem with internet. He/she is encouraged to use the approved customer care phone number and complete contact form and submit online with details of the problem.>>>>> Ongoing to STEP 11: The client is now part of our family. He/she is encouraged to share good news about our services to friends, relatives, neighbors, colleagues and even passersby. Encourage all to join our reliable internet family.>>>>> Ongoing to STEP 12: KNOW OUR MOTTO: We serve to satisfy>>>>>>>>>DID YOU UNDERSTAND OUR SERVICE CHARTER? Yes NoOur Institution is a service industry and we uphold a policy of ZERO TOLERANCE to any form of discrimination, verbal abuse, physical abuse or unethical behaviour when dealing with staff and vice versa. Please indicate in this space below if you understand this zero tolerance policy.Review Terms and conditions for service as provided then endorse the agreement by writing your full names in the space below Yes, I want to proceed No, I withdraw nowDo you need any further Explanation on any section of the Service agreement before you proceed with endorsement of contract for service? Yes NoDECLARATION: I declare that the information given above was voluntary and truthful to the best of my knowledge Yes NoI willingly enter to contract with Glovynet Virtual Interlinks Ltd and fully inderstand the terms and conditions as displayed in the service agreement and available online for me to review from time to time for compliance. Yes NoIndicate your full official names and your ID number below it to endorse this agreement:Submission Date and time (Please use arrows to select correct time)Submit Form
