Contract Subscribe to your mobile plan online Ready to choose your mobile offer? Fill out the form below so our Client Services team can finalize your contract as quickly as possible. Step 1 of 10 - Choices 10% Which service(s) do you need?Choices* Mobile ONE (INTERNET & MOBILE) Mobile Plan* XL - 40GB L - 10GB M - 1GB BASIC Mobile OptionsI would like to add 5GB of data to my plan for 9€/month:*Valid in Luxembourg and in Europe (zone 1) Yes No I would like to add 1GB of data to my plan for 5€/month:*Valid in Luxembourg and in Europe (zone 1) Yes No I would like to add 30 minutes of calling time to my plan for 5€/month:*Valid in Luxembourg and in Europe (zone 1) Yes No I would like to add a pack of 30 SMS to my plan for 5€/month:*Valid in Luxembourg and in Europe (zone 1) Yes No Internet OptionsDo you already have a modem with Eltrona?* Yes No MAC address MTA Serial Number I want to rent a FRITZ!Box 6660 for 6€/month*If you do not already have a modem, it is required to rent to a FRITZ!Box. I subscribe Your Contact DetailsTitle*MrMrs/MsFirst name* Name* Date of birth* DD slash MM slash YYYY City of birth* Country of birth* Phone number* Email* Preferred language of contact*LUDEENFR Invoicing And PaymentAdresse de facturation* Street Name And Number Floor/Apartment City/Town Postal Code Receiving your SIM CardI would like to receive my SIM card: At home In shop We will use the billing address to send you your SIM card by post. Installation InformationInstallation Address* L’adresse d’installation est identique à l’adresse de facturation. Street Name And Number Floor/Apartment City/Town Postal Code Type d'habitation*Single-family homeApartment buildingDesired Date of Activation (internet)* DD slash MM slash YYYY We cannot guarantee this date but we will do our best to respect your request.I am a new Eltrona customer?* Yes No I am already an Eltrona customer (without internet subscription)?* Yes No (I already have an internet subscription) Porting Your Existing Mobile Phone NumberIf you want to keep your existing phone number, please check the box, and fill out the information below.Do you want to keep your existing phone number?* Yes No Family Name of the Ordering Party* First Name of the Client* Account Holder (If Different) Client Number* SIM card number of the current operator* Current operator* Phone number for porting* Phone bookBy default, your mobile phone number will not appear in the phonebook.I want my mobile phone number to appear in the phone book:* Yes No Porting Your Existing Landline Phone NumberIf you want to keep your existing landline phone number, please check the box, and fill out the information belowDo you want to keep your existing phone number?* Yes No Family Name of the Ordering Party* First Name of the Client* Account Holder (If Different) Account Number Of Current Provider* Client Number* Connection Number* Your landline detailsType of landline connection*AnalogueISDNOwn Switchboard*YesNoAlarm*YesNoFax*YesNoPhone number for porting* Phone bookBy default, your landline number will not appear in the phone book.I want my landline phone number to appear in the phone book:* Yes No SEPA MandateFor your convenience, please enter your banking information which will appear in the SEPA Mandate of your contract. Please be aware that the cost of ordering a SIM card will be charged via SEPA after the SIM card it sent to you, whether or not you request its activation. Family Name of the Ordering Party* First Name of the Client* IBAN Number* BIC Code of Bank* Address of the Ordering Party* Identique à l'adresse de facturation Street Name And Number Floor/Apartment City/Town Postal Code Accepting the General Terms and ConditionsThe only thing left to do is to consult and accept the general and specific conditions of our services to validate your orderGeneral Conditions* I declare that I have read the General Conditions See our General Conditions Specific conditions for Internet services* I declare that I have read the Specific Conditions for Internet Services See our Specific Conditions for Internet Services Specific Conditions for Data and Network Connections* I declare that I have read the Specific Conditions for Data and Network Connections See our Specific Conditions for Data and Network Connections Specific Conditions for Landline Telephone Services* I declare that I have read the Specific Conditions for Landline Telephone Services See our Specific Conditions for Landline Telephone Services Utilization of Personal Data* I accept that my personal data will be used in conformance with the Privacy Policy published by Eltrona Interdiffusion S.A. See our Privacy Policy. HiddenDate de soumission NameThis field is for validation purposes and should be left unchanged.
