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Nepal Telecom Wi-Max Subscription Form

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Nepal Telecom Wi-Max Subscription Form Powered By Docstoc
					                                                 NEPAL TELECOM                                                          passport size
                                          (Nepal Doorsanchar Company Limited)                                          photograph with
                                                                                                                          Customer
                                                                                                                         authorised
                                              APPLICATION FORM                                                            signature
                                 Broadband Wireless Service ( [ ] WiMAX [ ] Wifi )


 1.   Customer’s Name (in BLOCK LETTERS):


 2.   Customer’s Permanent Address:
      Ward No            House No           Street Name                                    Tole Name


      Zone                                  District                                VDC/Municipality


 3.   Installation Address:
      Ward No           House No            Street Name                                    Tole Name


      Zone                                  District                                VDC/Municipality


 4.   Customer’s Mobile:                                                 Email:

 5.   Customer’s Identity:         Citizenship            Passport           PAN            Others     specify

      Number:                                          District:

 6.   Name of Company/Firm/Organization:

 7.   Company/Firm/Organization’s Full Address:



 8.   Customer’s ID:

 9.   Type of CPE required:                 Outdoor                      Indoor                      USB Dongle

10.   Packages:                             256 Kbps                     512 Kbps                    1Mbps or above
11.   Type of User:                         Single                       Multiple

12.   Purpose:                              Residence                    Business                    Government



          Site Map of the user’s premises from the Main Road ……………………………....
                                                                                                               Finger Prints
      N   Distance of residence is ….......………. meters from nearest Main Road.




                                                                                                            right                left




                                                                                                       .......................................
                                                                                                          Customer’ Signature
                                                                                                             Date : 20 /               /
                                                     FOR OFFICE USE ONLY

A Application Received Date                                                                                     Receipt No

B CPE Make                                                                                                      Model

C MAC CPE

D Date of activation

E Vendor                                                                                                                      ................................................
                                                                                                                              Signature
                                                                                                                              Name
                                                                                                                              Designation



                                g]kfn 6]lnsd / >L ===================================================================aLr ;DkGg ePsf]


                                                                          ;Demf}tf
g]kfn 6]lnsd - h;nfO{ o;kl5 sDkgL egL ;Daf]wg ul/Psf] 5 _ / >L ========================================== sf] gftL÷gftLgL, >L =========================== sf] 5f]/f÷5f]/L
>LdtL, =========================== lhNnf ================== dxfgu/kflnsf ÷ pkdxfgu/kflnsf/ ÷gu/kflnsf ÷uf=la=;=,a8f g+ ===== a:g] g]kfn 6]lnsd4f/f ljtl/t Wimax
Outdoor / Indoor/ USB Dongle sf] df]8]n g+ ==================================== sf u|fxs aif{ ======= sf] >L ============================= gf=k|=g+= =================== gf=k|=g+
ljt/0f ePsf] lhNNff =========================== - h;nfO{ o;kl5 u|fxs egL ;Daf]wg ul/Psf] 5 _ aLr ;]jf pkef]u ug]{÷u/fpg] p2Zon] lgDg pNn]lvt zt{x? kfngf ug{
b'a} kIf ;xdt e} b:tvt ;lx5fk u/L Ps–Ps k|lt a'lem lnof}+,lbof}+ .


zt{x? M
!= ;]jf pkef]usf] nflu sDkgL4f/f ljls| ul/g] Wimax Outdoor/ Indoor/ USB Dongle sf] d'No – sDkgLdf ;]6 df}Hbft /x] ;Dd,_ Activation Charge,
;+rfng dx;'n b/ tyf g]kfn ;/sf/n] tf]s] adf]lhdsf] s/ /sd u|fxsn] sDkgLdf a'emfpg' kg]{5 .

@= u|fxsnfO{ sDkgL4f/f ljls| u/]sf] ;]6df ljls| u/]sf] ldltn] # dlxgfsf] cjlwleq ;]6sf] pTkfbg v/fljsf] sf/0fn] u|fxssf] c;fjwfgLn] ubf{ pQm ;]6 6'6km'6 ePdf
jf x/fPsf] cj:yfdf sDkgLn] lgwf{/0f u/]sf] d'No u|fxsaf6 c;'n u/L gofF Wimax Outdoor/ Indoor/ USB Dongle pknAw u/fOg]5 .

#= pQm cjlw kZrft Wimax Outdoor/ Indoor/ USB Dongle h'g;'s} k|sf/sf] v/flj cfPdf klg sDkgLn] lgwf{/0f u/]sf] Wimax Outdoor/ Indoor/
USB Dongle sf] d'No u|fxsaf6 c;'n u/L gofF Wimax Outdoor/ Indoor/ USB Dongle pknAw u/fOg] 5 .

$= sDkgLaf6 Wimax Outdoor/ Indoor/ USB Dongle lnPsf u|fxsx?n] h'g 7]ufgf lnPsf] xf] ;f]xL 7]ufgf dfq pQm ;'lawf ;Frfng ug'{ kg]{5 .

%= Wimax Outdoor/ Indoor/ USB Dongle x/fPdf cljnDa ;DalGwt sfo{nodf lnlvt ;"rgf lbP/ ;]jf aGb u/fpg' kg]{5 . ;]jf k"gM ;+rfngsf] nflu j'Fbf
# cg';f/ dx;'n e'QmgL ug'{kg]{5 .

^ pkef]u u/]sf] ;]jf cj?4 ePdf u|fxsn] sDkgLsf] 6]lnkmf]g dd{t zfvfsf] tf]lsPsf] :yfgdf ;"rgf ug' kg]{ 5 . ;"rgf k|fKt kZrft\ sDkgLn] Fault kQf nufO{
cj?4 ;]jf cljnDa ;'rf? u/Lg]5 .

&= h'g;'s} k|of]hgsf] nflu ;]jf lnPsf] ePtf klg of] ;Demf}tfsf zt{, b"/;+rf/ P]g, lgod, gLlt Pj+ cGo k|rlnt sfg"gsf] k|lts'n x'g] ul/ u}/ sfg"gL tyf cglws[t
?kdf ;]jf k|of]u ePsf] kfOPdf sDkgLn] ;]jf aGb u/L k|rlnt P]g sfg"g cg';f/ sf/jfxL ug]{5 .

*= s'g} klg u|fxsn] lnPsf] ;]jf, ;'ljwf hf]];'s}n] k|of]u u/]sf] ePtf klg ;f] sf] lhDd]jf/L h;sf] gfddf btf{ ePsf] 5 ;f]xL u|fxsn] g} axg ug'{ kg]{5 .

( ;]jf;+u ;DjlGwt cGo yk ;'ljwfx? Tff]lsP adf]lhdsf] /sd a'emfO{ u|fxsn] dfu u/]sf] v08df Ifdtfn] EofP;Dd sDkgL4f/f pknAw u/fOg]5 .

!)= ;]jf;+u ;DalGwt sDkgLn] ljBdfg gLlt, lgod, ljlgod eljiodf x'g] kl/jt{g tyf eljiodf aGg] gofF gLlt, lgod, ljlgod ;DjlGwt lgsfosf] :jLs[lt k|fKt
ePkl5 ;fj{hlgs ;"rgf k|sflzt u/] kZrft pQm gLlt, lgod, ljlgodx? b'a} kIfnfO{ dfGo x'g] 5 To;nfO{ of] ;Demf}tfsf] cleGg cu+ dflgg] 5 .

!!= o; ;Demf}tfdf pNn]lvt zt{x? kl/jt{g tyf yk ug'{ k/]df g]kfn b"/;+rf/ k|flws/0fsf] :jLs[tL kZrft ;fj{hlgs ;"rgfaf6 yk jf kl/jt{g ug{ ;Sg]5 . o;/L
;"rgfaf6 yk ePsf zt{x? o; ;Demf}tfsf] cleGg cu+ dflgg] 5 t/ zt{ kl/jt{g ubf{ !% lbg cufj} u|fxsju{x?nfO{ ;"lrt ul/g] 5 .

				
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Description: Nepal Telecom Wimax service subscription PDF form