We are a solution to everyone in the motor vehicle value-chain. Servicing motorists, fleet management and logistics companies.

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Contact

082 767 5416

1 Indwe Road, Fort Jackson Industrial Area, Mdantsane, East London 5219

info@intsika.myblisstech.com

Corporate Plan

Corporate Plan

Corporate Plan Application Form

  • To be completed by all companies seeking registration as certified AutoHost Subscriber Companies;
  • The questionnaire must be completed in full and be signed;
  • All fields on application form MUST be completed by the applicant;
  • Applicants will be contacted via email or fax and must therefore submit an email address and fax number;
    failure to comply will result in declining the application;
  • It should be noted that AutoHost reserves the right to accept or reject any application in this respect;
  • Applicants must comply with all the registration-criteria for registration to be finalized - failure to do so may result in the application being declined.

Name
Name
First
Last
Address
Address
City
Province
Zip/Postal

Vehicle Information

Is Vehicle Financed?
Is Vehicle Insured?

Consent

By submitting this form, you give consent to AutoHost to share your details with our partners for quotation purposes on:

  1. Insurance (vehicle and/or premises)
  2. Vehicle tracking system
  3. Vehicle Finance