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Student Broadband Package Application Form

Student Information

Name Ms Faiza Shahbaz

Registration # 81110

Mobile #

Home Phone # 42New Connection

Email Address waji_83@yahoo.com

Customer Type Student

NIC # 35200-6622835-2

Package Information

Broadband Phone # 42New Connection

City Lahore

Package 1 MB

University Information

University Name Insituite of Management Sciences

Department MBA - Human Resources

University City Lahore

University Contact Number 421191938

Date Of Enrolment 02-OCT-2008

Date of Completion 02-NOV-2010

University Verification

Name of Registrar/Dean/Principal/faculty .............................................

Signature & Stamp .............................................

Signature of Student .............................................

For PTCL Use only

Login Choice 1 ws786

Login Choice 2 ...............................

Login Choice 3 ...............................

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