Bharat Sanchar Nigam Limited Form

I want internet connection for my computer. I want to apply for Broadband Connection of Bharat Sanchar Nigam Limited. So will you give application form to apply for Broadband Connection of Bharat Sanchar Nigam Limited?

As you want to download application form to apply for Broadband Connection of Bharat Sanchar Nigam Limited, so here I am providing following form:

You have to fill following details on Application Form:

Existing BSNL Telephone No. on which Broadband connection is required:

Want to apply for a new connection: Yes No

Educational Qualification (Optional): Doctorate/Post Graduate/Graduate/Matriculate/Other

Title/Name of the Customer / Firm /Organization (SURNAME FIRST)

Billing Address:

Address of Connection (i.e. Installation Address):

Contact Tel. No.:
Resi
Off.:
Mob.:

E-Mail Address:
Broadband Service being applied for Prepaid □ Postpaid □
Modem Options (See tariff details)
Do you want BSNL to Provide Modem : Yes □ No

If Yes, then please tick any one of the following Options (i.e. A or B or C)
[ Type-I (Ethernet & One USB Port) ; Type-II (Ethernet & One Wi-Fi Port) ]

Option-1: Outright Modem Purchase from BSNL Type-I □ or Type-II □ (see conditions overleaf)

Option-2: Use BSNL Modem by paying Advance monthly Rental for Type-I or Type-II
& Refundable Security Deposit of Rs. 500/- (Applicable for Postpaid Broadband service only)

Option-3: Free Modem (Please see condition for providing free modem in tariff details) □
(Applicable for Postpaid Broadband service only):

Type of Broadband connection (See conditions overleaf) : Business Residential
(Applicable for Postpaid Broadband service only):

Choice of Tariff Plan :
(Applicable for Postpaid Broadband service only)

Recharge Options for the Prepaid Customers (see tariff details)
Payment option (Applicable for Postpaid Broadband service only): Monthly Annually

Choice of e-mail/user Ids

Nominee (Optional)

Customer signature

Franchisee Code, if any

Bharat Sanchar Nigam Limited Application Form for Broadband Connection

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Answered By StudyChaCha Member