New Service Activation Form

ATTN:
Dear Customer, please ensure this form is filled out completely, either by yourself or with assistance from our RapidNet staff, during the process of obtaining a new connection.

সম্মানিত গ্রাহক, নতুন সংযোগ গ্রহণের সময় দয়া করে এই ফর্মটি সম্পূর্ণভাবে পূরণ করুন। আপনি চাইলে এটি নিজে পূরণ করতে পারেন অথবা আমাদের RapidNet স্টাফের সহায়তা নিতে পারেন।

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Service Type *

• Residential
• Office/Business
• GOV./NGO/EDU

Full Name *

As per National ID

Name of Organization

Mobile Number *

Secondary Contact Number

Email *

NID/Passport Number

NID/Passport Number

Connection Address

Flat/Apartment #

Area

House Number

City *DinajpurRangpurPhulbariBadargonjOther

Road Number

Lat/Lon *

Lat/Lon or Google map link

Service Details

Service Plan *Rapid Lite - 20 Mbps @ 675 takaRapid ONE - 40 Mbps @ 840 takaRapid Prime - 50 Mbps @ 1050 takaSMOOTH - 35 Mbps @ 800 takaPRO - 45 Mbps @ 1000 takaECON-plus - 15 Mbps @ 600 takaFAST - 55 Mbps @ 1200 takaADVANCED - 65 Mbps @ 1500 takaMAX - 25 Mbps @ 700 takaEcon - 10 Mbps @ 525 taka

Device (ONU) *I will provide EPON/XPON ONUNeed New ONUNot Sure

Customer Wifi Router Type *Single BandDual BandI will need a new WiFi RouterNot Sure

Service Activation

Expected Service Stat Date *

Monthly Bill Payment Method

Bill Paymnet Options *

• I will Pay via Bkash
• I will Pay Cash at Office

Please Pay via bKash to avoid any hassle

OTC Details

Security Deposit Amount *

New Connection Fees *

Monthly Bill *

TOTAL AMOUNT (Security Deposit + Monthly Bill + New Connection) *

Invoice/Receipt Number *

Note

Note

Picture of House/Location & NID/ID *

Drag & Drop Files, Choose Files to Upload You can upload up to 4 files.

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