Fixed Mobile Geolocation

In association with

When entering your home address, ensure the RED Pin on the Map is placed directly on your house
If you have trouble finding your address, find the nearest known address on the map and drag the pin onto your house
If you are doing this from a Cellphone, provided you have Location Services enabled, it will detect your location
Use the Address Comments field if you live in a complex, or apartment, or if the Google Maps address is not specific enough,
be as detailed as possible as if you were having a parcel delivered.

Staff Prefix (OM, X, XY etc)

Incorrect prefix.

Staff Code (6-Digits)

Incorrect Staff Code.

First name

Valid first name is required.

Last name

Valid last name is required.

Mobile Number

Please enter your mobile number.

Email (Old Mutual email address)

Please enter a valid email address.

Please select your Business Unit

Please enter your business unit.

Do you have an OM data sim card(s)

Please enter indicate your sim card connecitivity.

If you have OM data sim, please provide the sim serial number in the box(es) below

Please enter your sim serial number.

What personal internet connectivity do you Have at home

Please enter your current connectivity.

Do you use your personal connectivity for work?

Please indicate if you already have connectivity at home.

Home Address

Please enter your address.

Address Comments (apartment, unit, building, floor etc)

Please enter additional address information if required.

Survey is currently closed