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ITC CUSTOMER REQUIREMENT FORM
Customer Details
Customer Details
Customer Name/Company
*
Business Type
Representative
*
Representative Designation
Address
Tel
*
Fax
Rep Tel
Rep Email
*
Service Details
Service Details
Required Capacity Rate (Mbps)
A-end Address
A-end Address
Circuit Protection Options
Protected
Partially Protected
Unprotected
Service Period (mo)
1
2
3
4
5
6
7
8
9
10
11
12
Year
1
2
3
4
5
Month
Target RFS Date
Please mention any additional requirements or dependencies
CONNECT WITH US
House No. Ga-30/G,
Pragati Sarani, Shahjadpur,
Gulshan, Dhaka – 1212,
Bangladesh.
Phone: +8809638-382-222
E-mail: info@novocom-bd.com
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