Download Application Form - Nepal Telecom
Download Application Form - Nepal Telecom
Download Application Form - Nepal Telecom
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NEPAL TELECOM<br />
(<strong>Nepal</strong> Doorsanchar Company Limited)<br />
APPLICATION FORM<br />
Broadband Wireless Service ( [ ] WiMAX [ ] Wifi )<br />
passport size<br />
photograph with<br />
Customer<br />
authorised<br />
signature<br />
1. Customer’s Name (in BLOCK LETTERS):<br />
2. Customer’s Permanent Address:<br />
Ward No House No Street Name Tole Name<br />
Zone District VDC/Municipality<br />
3. Installation Address:<br />
Ward No House No Street Name Tole Name<br />
Zone District VDC/Municipality<br />
4. Customer’s Mobile: Email:<br />
5. Customer’s Identity: Citizenship Passport PAN Others<br />
specify<br />
Number:<br />
District:<br />
6. Name of Company/Firm/Organization:<br />
7. Company/Firm/Organization’s Full Address:<br />
8. Customer’s ID:<br />
9. Type of CPE required: Outdoor Indoor USB Dongle<br />
10. Data Rate (Speed): 256 Kbps 512 Kbps 1Mbps or above<br />
11. Volume in GB:<br />
12. Validity:<br />
N<br />
Site Map of the user’s premises from the Main Road ……………………………....<br />
Distance of residence is ….......………. meters from nearest Main Road.<br />
Finger Prints<br />
right<br />
left<br />
.......................................<br />
Customer’ Signature<br />
Date : 20 / /
FOR OFFICE USE ONLY<br />
A <strong>Application</strong> Received Date<br />
B CPE Make<br />
Receipt No<br />
Model<br />
C MAC CPE<br />
D Date of activation<br />
E Vendor ................................................<br />
Signature<br />
Name<br />
Designation<br />
g]kfn 6]lnsd / >L ===================================================================aLr ;DkGg ePsf]<br />
;Demf}tf<br />
g]kfn 6]lnsd - h;nfO{ o;kl5 sDkgL egL ;Daf]wg ul/Psf] 5 _ / >L ========================================== sf] gftL÷gftLgL, >L =========================== sf] 5f]/<br />
f÷5f]/L >LdtL, =========================== lhNnf ================== dxfgu/kflnsf ÷ pkdxfgu/kflnsf/ ÷gu/kflnsf ÷uf=la=;=,a8f g+ ===== a:g] g]kfn 6]lnsd4f/f<br />
ljtl/t WiMAX Outdoor / Indoor/ USB Dongle sf] df]8]n g+ ==================================== sf u|fxs aif{ ======= sf] >L ============================= gf=k|=g+=<br />
=================== 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]<br />
lvt zt{x? kfngf ug{ b'a} kIf ;xdt e} b:tvt ;lx5fk u/L Ps–Ps k|lt a'lem lnof}+,lbof}+ .<br />
zt{x? M<br />
!= ;]jf pkef]usf] nflu sDkgL4f/f ljls| ul/g] WiMAX CPE (Outdoor/Indoor/USB Dongle) sf] d"No, Activation charge, ;+rfng dxz"n b/ tyf g]kfn<br />
;/sf/n] tf]s] adf]lhdsf] s/ /sd u|fxsn] sDkgLdf a'emfpg' kg]{5 .<br />
@= 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<br />
jf x/fPsf] cj:yfdf sDkgLn] lgwf{/0f u/]sf] d'No u|fxsaf6 c;'n u/L gofF WiMAX CPE pknAw u/fOg]5 .<br />
#= pQm cjlw kZrft WiMAX CPE h'g;'s} k|sf/sf] v/flj cfPdf klg sDkgLn] lgwf{/0f u/]sf] WiMAX CPE sf] d'No u|fxsaf6 c;'n u/L gofF WiMAX CPE<br />
pknAw u/fOg] 5 .<br />
$= u|fxsn] sDklgn] tf]s]sf] cflwsfl/s ljs|]tf dfkm{t WiMAX CPE vl/b u/]df, u|fxs / las|]tf ljrsf] zt{x? nfu' x'g]5 .<br />
%= sDkgLaf6 WiMAX Outdoor CPE lnPsf u|fxsx?n] h'g 7]ufgfdf lnPsf] xf] ;f]lx 7]ufgfdf dfq pQm ;]jf ;+rfng ug'{ kg]{5 .<br />
^= WiMAX CPE x/fPdf cljnDj ;DalGwt sfo{nodf lnlvt ;"rgf lbP/ aGb u/fpg' kg]{5 . ;]jf k'g ;+rfngsf] nflu glhssf] sfo{no jf u|fxs ;]jf s]Gb|df<br />
;Dks{ ug'{ kg]{5.<br />
&= pkef]u u/]sf] ;]jf cj?4 ePdf u|fxsn] sDkgLsf] tf]lsPsf] :yfgdf ;"rgf ug'{ kg]{5 . ;"rgf k|fKt kZrft\ Fault kQfnufO{ cj?4 ;]jf cljnDa ;"rf? ul/g]5 .<br />
*= 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 .<br />
( ;]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 .<br />
!)= ;]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<br />
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 .<br />
!!= 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<br />
;"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 . Psk6s h8fgul/ ;+rfngdf<br />
cfPsf] pks/0f tyf ;]jflkmtf{ ul/g] 5}g .<br />
!@= cfkm\gf] afx]s c?sf] gfddf ;]jf lng k/]df cfkm\gf] kl/rokq / kmf]6f] ;]dt clgjfo{ k]z ug{‘ kg]{5 .