DIGITAL TELECOM INTERNATIONAL

Digital Telecom International

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Subscription Form

Name:
Designation:
Organization:
Address:
Tel:
Fax:
E-mail:
Residence:
Date of Birth:	(e.g.1975)
Marital Status:	Single Married Widow Widower
Gender:	Male Female
Marriage Anniversary:	(MM/DD/YY)
Bill to be sent to:	Office Home
Profession:
Service:	Nationwide City
Value Added Service: (Use Ctrl key for multiple selection)
Order Pagers:	Numeric Alphanumeric Nepali/English Alphanumeric 2 Line English Alphanumeric 4 Line English
Referred By:	Name :
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