ENTERPRISE COMBO SERVICE REQUEST FORM


Service Detail:

Service Request Type *
Service Type*
Service Number *
Bandwidth Speed *
Consolidated/Existing Account Number
Address Information: New Address Information:
Region* New Region *
Zone/Sub city/Main City * NewZone/Sub city/Main City*
Woreda* New Woreda *
Kebele New Kebele
Building Name New Building Name
House Number New House Number
Specific Location New Specific Location

Company Informations:

Company Name *
Mobile Number *
Additional Contact Number
Contact Person *
Email

*