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ORDER FORM
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Name
..Nationality
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Type of customer: |
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Residential: |
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Business: |
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Government: |
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Student: |
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Other:
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ID Type:
ID No: |
(Copy of a document is Required) |
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Commercial Registration (For Business Only): |
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(For Business Only) |
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Address:
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Contact Name:
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Contact Tel. Number: |
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A COMMERCIAL GUARANTEE IS REQUIRED |
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Other TeleYemen Service Provided to the
Customer:
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IDD Number: |
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Mobile Numbers: |
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Y.net User Name: |
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...................... |
..................... |
....................... |
....................... |
........................ |
................... |
(Write down the desired username for your
account. Use alphanumeric A-Z/0-9. 1st character must be alphabetic).
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First Choice |
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Please, note that your Username
Will be your e-mail address |
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Sec. Choice |
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Initial password |
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Initial password should be changed by
Customer as soon as possible. |
Plan Name:
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Registration Charge: |
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Monthly Charge: |
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Computer Type:
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IBM Compatible |
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MAC |
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Others
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Please specify:
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Modem used: internal |
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External
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Type
Max. Speed
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I/We have read and understood TeleYemen Terms and Conditions for
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Service and have accepted them. |
Customer Name:
. Signature
Company name:
.. Stamp Date:
/ /
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Note: To
secure your Internet account you should change your password periodically
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Deposit Paid by : Cash |
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Cheque |
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Receipt No:
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Sponsorship letter |
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Letter from place of work |
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Guardian letter |
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Registration
No.:
Account No.:
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Branch
Salesman Date: / /
Stamp |
