ENTERPRISE FIXED LINE SERVICE REQUEST FORM


Service Detail:

Service Request Type*
Service Type *
Number of Line *
Consilidated /Existing Account Number
Service Number*
Address Information: New Address Information:
Region * New Region*
Zone/Sub city/Main city* NewZone/Sub city/Main city*
Woreda* New Woreda*
Kebele NewKebele
Building Name NewBuilding Name
House Number New House Number
Specific Location NewSpecific Location

Company Informations:

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

*