Customer Registration Form (Broadband Internet)
for All
(Fields with
*
are must required)
Full Name
*
Mobile No.
*
Email Address
*
NID
(Optional)
District
*
select
ID
NAME
Upazila/Thana
*
select
ID
NAME
Address
*
Connection For
*
select
ID
NAME
Package
*
select
ID
NAME
1
PACKAGE 1+5%VAT 12 Mbps for Home
2
PACKAGE 2+5%VAT 20 Mbps for Home
3
SME PACKAGE 1+5%VAT 20 Mbps for Home
4
SME PACKAGE 1+REAL_IP+5%VAT 20 Mbps for Home
5
SME PACKAGE 2+5%VAT 25 Mbps for Home
6
SME PACKAGE 2+REAL_IP+5%VAT 25 Mbps for Home
7
SME PACKAGE 3+5%VAT 30 Mbps for Home
8
SME PACKAGE 3+REAL_IP+5%VAT 30 Mbps for Home
9
PACKAGE 3+5%VAT 35 Mbps for Home
10
PACKAGE 4+5%VAT 50 Mbps for Home
11
PACKAGE 4+REAL_IP+5%VAT 50 Mbps for Home
12
PACKAGE 5+REAL_IP+5%VAT 60 Mbps for Home
13
PACKAGE 5+5%VAT 60 Mbps for Home
14
PACKAGE 6+5%VAT 75 Mbps for Home
15
PACKAGE 6+REAL_IP+5%VAT 75 Mbps for Home
16
PACKAGE 7+5%VAT 90 Mbps for Home
17
PACKAGE 7+REAL_IP+5%VAT 90 Mbps for Home
18
PACKAGE 8+5%VAT 110 Mbps for Home
19
PACKAGE 9+5%VAT 140 Mbps for Home
!
MRC
OTC
Sub-Total
Discount (OTC)
Discount (MRC)
Net MRC
Net OTC
Total Net Payable
Verification Code
Code
*
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