Switch to Proximus

All fields are mandatory except those where "optional" is mentioned.

Your personal data

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{{errorMessages.FirstName.required}} {{errorMessages.FirstName.pattern}} {{errorMessages.FirstName.pattern}} {{errorMessages.FirstName.pattern}} {{errorMessages.FirstName}}
{{errorMessages.LastName.required}} {{errorMessages.LastName.pattern}} {{errorMessages.LastName.pattern}} {{errorMessages.LastName.pattern}} {{errorMessages.LastName}}
Installation address
{{errorMessages.StreetName.required}} {{errorMessages.StreetName.pattern}} {{errorMessages.StreetName.pattern}} {{errorMessages.StreetName.pattern}} {{errorMessages.StreetName}}
{{errorMessages.HouseNumber.required}} {{errorMessages.HouseNumber.pattern}} {{errorMessages.HouseNumber.pattern}} {{errorMessages.HouseNumber.pattern}} {{errorMessages.HouseNumber}}
{{errorMessages.Letter.required}} {{errorMessages.Letter.pattern}} {{errorMessages.Letter.pattern}} {{errorMessages.Letter.pattern}} {{errorMessages.Letter}}
{{errorMessages.zipCode.required}} {{errorMessages.zipCode.pattern}} {{errorMessages.zipCode.pattern}} {{errorMessages.zipCode.pattern}} {{errorMessages.zipCode}}
{{errorMessages.cityName.required}} {{errorMessages.cityName.pattern}} {{errorMessages.cityName.pattern}} {{errorMessages.cityName.pattern}} {{errorMessages.cityName}}
{{errorMessages.contact_number.required}} {{errorMessages.contact_number.pattern}}
{{errorMessages.CALLBACKCLI.required}} {{errorMessages.CALLBACKCLI.pattern}} {{errorMessages.CALLBACKCLI.pattern}} {{errorMessages.CALLBACKCLI.pattern}} {{errorMessages.CALLBACKCLI}}
{{errorMessages.CALLBACKCLI.required}} {{errorMessages.CALLBACKCLI.pattern}} {{errorMessages.CALLBACKCLI.pattern}} {{errorMessages.CALLBACKCLI.pattern}} {{errorMessages.CALLBACKCLI}}
{{errorMessages.MAILBACKADDR.required}} {{errorMessages.MAILBACKADDR.pattern}} {{errorMessages.MAILBACKADDR.pattern}} {{errorMessages.MAILBACKADDR.pattern}} {{errorMessages.MAILBACKADDR}}
{{errorMessages.install_date.required}} {{errorMessages.install_date.pattern}} {{errorMessages.install_date.pattern}} {{errorMessages.install_date.pattern}} {{errorMessages.install_date}}
I'm interested in the following products:
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{{errorMessages.cable_present.required}} {{errorMessages.cable_present.pattern}}

A cable for the introduction looks like this :

A NTP socket or junction box (apartment) can give an indication that there is a cable for the introduction present :

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