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Customer name: *
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Customer Company name:
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Customer Account number:
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(Account number must contain exactly 7 numeric characters.)
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Customer Reference number:
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Please provide Email address:
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Please provide a Contact number: *
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How satisfied are you with the service provided by Afrox?:
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What was the reason for your rating?:
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How likely are you to recommend Afrox to your friends and family?:
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