SIM Trial Order Form

SIM Trial Order Form Asia-Pacific
Name *

First Name Last Name
Company Name / Legal Name (if different) *
Contact Phone Number *

Area Code Phone Number
Contact Email *
Accounts Contact Phone Number
Accounts Email
VAT number or equivalent *
Are you a reseller? *
No. of SIMs *
No. of SIMs *
Data usage per SIM per month (ie. 2MB, 5MB, etc.) *
Do you require SMS or Voice?
Trial Length (1-3 months) *
Countries where SIMs will be used (ie. EU, US, Africa, South America, etc.) *
Network Type *
Network service required *
e.g. UKJ, ROCT, etc...
SIM Card Form Factor *
Expected no. of SIMs first 12 months *
Sectors *
What currency you want to pay *
How did you hear about us? *
Registered Address *

Street Address

Street Address Line 2

City State / Province

Post Code Country
Shipping Address (If Different)

Street Address

Street Address Line 2

City State / Province

Post Code Country
Special request
Should be Empty: