Client Name*

Package* Smart Pack-1 (525.00 - 15Mbps) Smart Pack-2 (630.00 - 25Mbps) Smart Pack-3 (840.00 - 40Mbps) Smart Pack-4 (1050.00 - 50Mbps) Smart Pack-5 (1200.00 - 50Mbps) Smart Pack-6 (1500.00 - 60Mbps) 3000TK-Pkg6 (3000.00 - 100Mbps)

Type of Connectivity* Shared Dedicated

Payment Method* Cash from Home Cash Office bKash Rocket iPay Card Bank Corporate

Signup Fee

Cell No*

Alternative Cell No 1

Address

Occupation

Email

National ID

Previous ISP

Feedback

Image

NID Front Side

NID Back Side

Agree With Our Conditions Yes     No