Preferred Customer Enrollment Form

All fields with (*) are required fields.

Code Activation
Purchased Code from i-fern Teller
Personal Details
     Male            Female

18 And Above Only


Sample format: 09xx-xxx-xxxx

Secondary mobile # if any

Enter fullname

Relationship to owner

Address Information
Account Details
Choose your username wisely, as this cannot be changed. Username is case-sensitive.


  I agree to I-FERN Terms and Conditions

  I agree to I-FERN Data Privacy Policy

  I agree to "I-FERN Principles, Policies & Procedures". (Please read and click the link before ticking the box)