Dhiraagu - postpaid application form







Personal Information

	Company/Office/Applicant's Name :

	Contact Name :

	Nationality :

	ID card / PP no :

	Title :

	Date service required :

	Contact No's :


Full address of applicant

	House/Building Name :

	Road Name :

	District :

	Block No :

	Atoll/Island :


Full billing address (if different)

	House/Building Name :

	Road Name :

	District :

	Block No :

	Atoll/Island :


Type of service required

	Install new telephone line(s)

	ISDN-2 ISDN-30 ISDN-8 Plus (off male' only)

	Change existing telephone no. to ISDN:

	Provide additional directory no.

	Install telephone telephone instrument on telephone no.

	Relocate telephone no. in same premise

	Relocate telephone no. to my new address above

	Become the registered user/owner of the telephone no.

	Name (present owner):

	ID card no. (present owner) :

	provide/remove Ex-dir service to/from

	Internal wiring of telephone no.

	Disconnect telephone no.

	Starlock Password

	Others



To be filled by off-male' customers only

Minimum number of ISDN channels will be 8 channels(if applying for ISDN-8 Plus)

	specify the number of additional channels required (multiples of 2) [subject to availabilty of radio capacity]


	Has a telephone service been provided previously at this address? If yes, state the number :

	Type of equipment required (if known)

	Date service required

I/We hereby agree to abide the Terms and Conditions for provision Telecommunications Service by Dhiraagu as contained in the current edition of the telephone directory and any ammendments there to be made from time to time.

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