Personal Information
* All fields are mandatory except Mobile
 
Customer Title :    
   
First Name :         
Last Name :         
Mobile Number :  
(To receive alert as SMS -- later on)
    
E-Mail :         
UserID :  
(Minimum 5 characters)
    
Password :  
(Minimum 5 characters)
    
Confirm Password :         
Customer Account Number :
(As available on the Telephone Bill)    
    
Telephone Number :         
Bills in Email :    I hereby agree to receive the bill through email ONLY
(Once the request for E-bill subscription is processed, hard copy bills will be discontinued.)