Cancellation – Rapid Networks

//Cancellation

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Name(Required)

First Last

ID Number(Required)

Username(Required)

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City Postal Code

Reason for Cancellation(Required)

CPE (Customer Premises Equipment) remains the property of the client ONLY if it was purchased.(Required)

I Agree

Clients who rent equipment from Rapid Networks will make arrangements for collection of equipment due to cancellation.(Required)

I Agree

The customer remains liable to Rapid Networks for any amounts owed to the supplier in terms of that agreement up to the date of cancellation.(Required)

I Agree

I, the above stated, hereby give my 30 days cancellation notice (unless agreed otherwise).(Required)

I Agree

Service End Date

Date

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