IMPORTANT NOTES
  1. Please check your area is within Allo’s coverage area here .
  2. Please read all the Term and Conditions accompanying in the subscription of the Service(s) before completing this application.
  3. Please write in CAPITAL LETTERS and tick (✔) where required.
  4. You must proceed with the upfront payment to complete your subscription and to enjoy the promotion price. The upfront payment is applicable for City Broadband residential package only. Other Value –Added – Service (VAS) is excluded.
  5. Allo will proceed with broadband installation upon received the payment.
  6. All upfront payment is non-refundable. Refunds will be made in Ringgit Malaysia (RM) via bank transfer within 30 days from the submission date only if the application is not successful (if applicable).
  7. Customer must provide payment receipt as proof of payment.
  8. A minimum of remaining months or RM500 whichever higher will be imposed as termination charges on service termination within contract period as stipulated in the Terms & Conditions accompanying the subscription of the Service(s).

A. INSTALLATION INFORMATION

State *
City *
Select State First
Full installation area *

 

Preferred appointment date *
Preferred appointment time *
Note:
  • The earliest appointment date is 5 days not including Sunday and Public holidays.
  • Preferred appointment date and time is subject to the service installer availability.
  • No installation on Sunday and Public holidays.

B. CUSTOMER INFORMATION

Name (Individual Name as per IC/Passport) *
Nationality *
Note: A deposit of RM300 will be charge upfront prior submission.
MyKad/Passport Number *
Contact Number (Primary) *
Contact Number (Secondary)

Not mandatory

Email Address *

C. SERVICE PACKAGE DETAILS

Please choose your package plan *
  100Mbps RM99 RM89
      Pay RM300 Now, Enjoy RM0 for 1st 6 months

  300Mbps RM129 RM109
      Pay RM300 Now, Enjoy RM0 for 1st 6 months

  500Mbps RM139
      Pay RM500 Now, Enjoy RM0 for 1st 6 months

  1Gbps RM199
      Pay RM750 Now, Enjoy RM0 for 1st 6 months

Promotion type and contract *
   Pay Now, RM0 for 1st 6 months.

   Contract Term 24 months.


Non-Malaysian Deposit Fee
  RM300
Deposit Fee will be refundable upon service termination. T&Cs apply

Voice Home Plan
  Add on Voice Home Plan


Service Subscription Details
Description Price excludes ST Total include ST
City Broadband Residential
RM99.00 RM89.00
Voice Home Plan fee
Total Monthly Charges -

Upfront Payment
Description Price excludes ST Total include ST
Pay Now & enjoy 6 months Free
Non-Malaysian Deposit Fee
Total Upfront Payment Charges -

Total Payment *Price subject to 6% Service tax (if applicable)
*Promotional package and price valid for24 months only. Retail price will be automatically charge upon contract expiry.

D. REFUND BANK DETAILS

Name of Bank *
Bank Location *
Beneficiary Name *
Account Number *

E. DECLARATION

 

Photocopy of MyKad (front and back)or passport for Non-Malaysian (minimum 12 months validity) and visa (minimum 6 months validity)
 

I hereby consent to the collection, use, disclosure of my personal information in accordance with the Privacy Policy available on www.citybroadband.my.
 

I hereby declare that the above information, documents, and any appendices attached are true and valid. I have read and understood the contents of this form and agreed to be bound by General Term & Conditions ,Promotion Term & Conditions (if applicable) as stated on the next page of this form which accompany the subscription of product(s) and/ or service(s). Allo Technology Sdn Bhd reserve the rights to refuse any application at any given time should any of the information is incorrect.


Upload Documents

Acceptable formats: png,jpeg,pdf,jpg,heif

MyKad / Passport Front *

 

MyKad / Passport Back *