Application for SABEN Access Network Service (last-mile connectivity) Please fill in all the required fields below, once for each campus. Institution Name (required) ---DHETBoland CollegeBuffalo City CollegeCapricorn CollegeCentral Johannesburg CollegeCoastal CollegeCollege of Cape TownEast Cape MidlandsEhlanzeni CollegeEkurhuleni East COllegeEkurhuleni West CollegeElangeni CollegeEsayidi CollegeFalse Bay CollegeFlavius Mareka CollegeGert Sibande CollegeGoldfields CollegeIkhala CollegeIngwe CollegeKing Hintsa CollegeKing Sabata DalindyeboLephalale CollegeLetaba CollegeLovedale CollegeMajuba CollegeMaluti CollegeMnambithi CollegeMopani South East CollegeMotheo CollegeMthashana CollegeNorthern Cape Urban CollegeNkangala CollegeNorthern Cape Rural CollegeNorthlink CollegeOrbit CollegePort Elizabeth CollegeSedibeng CollegeSekhukhune CollegeSouth Cape CollegeSouth West Gauteng CollegeTaletso CollegeThekwini CollegeTshwane North CollegeTshwane South CollegeUmfolozi CollegeUmgungundlovu CollegeVhembe CollegeVusalela CollegeWaterberg CollegeWest Coast CollegeWestern CollegeOther Institution Name if other (required) Email Address (required) Campus name (required) Campus address- (where installation will be) (required) Building details (where installation will take place, preferably server room) (required) Geo-Coordinates (required) - Hover over this field for instructions College IT Manager Name (required) Email (required) Telephone (required) Cellphone (required) Fax Campus Technician (Technical Contact - unique for each campus) (required) Email (required) Campus Telephone (required) Cellphone (required) Fax (optional) Alternate Contact Name Job Title Email Telephone Cellphone Fax [recaptcha]