Customer Application form

Step 1 of 8 - Choose Form Type

Please choose desired form type and Business Unit

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Wires & Wireless FORM TYPE

Coresol FORM TYPE

AudioNote FORM TYPE

This form, duly completed and signed must be submitted to Wires & Wireless (Pty) Ltd;

Details provided herewith will be used for billing purposes, Wires & Wireless (Pty) Ltd will not be held responsible for errors/incomplete information;

This form, duly completed and signed must be submitted to Coresol (Pty) Ltd;

Details provided herewith will be used for billing purposes, Coresol (Pty) Ltd will not be held responsible for errors/incomplete information;

This form, duly completed and signed must be submitted to AudioNote (Pty) Ltd;

Details provided herewith will be used for billing purposes, AudioNote (Pty) Ltd will not be held responsible for errors/incomplete information;

Please download and fill out this form in order to upload at the end of this application.

DOWNLOAD - T's & C's

Please note this submission will only be valid if signed by an authorized person of member.

Personal Data I/We consent to Coresol (Pty ) Ltd collecting, processing, storing, and providing personal details to its subsidiaries and associated entities and other departments for purposes of billing, marketing, and referring potential business opportunities from and by its subsidiaries and associated entities.

Financial Intelligence Centre Acts (FICA) All accountable institutions are required to identify their clients as required by the Financial Intelligence Centre Act No. 38 of 2001. We therefore consent to Coresol carrying out identity and fraud prevention checks and sharing that information as required.

Personal Data I/We consent to Wires & Wireless (Pty ) Ltd collecting, processing, storing, and providing personal details to its subsidiaries and associated entities and other departments for purposes of billing, marketing, and referring potential business opportunities from and by its subsidiaries and associated entities.

Financial Intelligence Centre Acts (FICA) All accountable institutions are required to identify their clients as required by the Financial Intelligence Centre Act No. 38 of 2001. We therefore consent to Wires & Wireless carrying out identity and fraud prevention checks and sharing that information as required.

Personal Data I/We consent to AudioNote (Pty ) Ltd collecting, processing, storing, and providing personal details to its subsidiaries and associated entities and other departments for purposes of billing, marketing, and referring potential business opportunities from and by its subsidiaries and associated entities.

Financial Intelligence Centre Acts (FICA) All accountable institutions are required to identify their clients as required by the Financial Intelligence Centre Act No. 38 of 2001. We therefore consent to AudioNote carrying out identity and fraud prevention checks and sharing that information as required.

Thus done and signed at:(Required)

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Contact us directly

What can we help You Achieve?

Stay ahead in a rapidly changing world.

All rights reserved 2025 © Agera Group

What can we
help You Achieve?