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Bida Application Form

This document is an application form for BIDA FIBER internet service. It requests the applicant's personal details such as name, date of birth, contact information, home address, household income, and employment details. It outlines the plan as a 35Mbps connection with a 3-year contract and unlimited data for up to 6 devices, but no LAN port. The installation fee is 1,500 pesos cash or 100 pesos installment for 18 months. The applicant and property owner must sign to authorize the application.

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nvingua1994
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947 views2 pages

Bida Application Form

This document is an application form for BIDA FIBER internet service. It requests the applicant's personal details such as name, date of birth, contact information, home address, household income, and employment details. It outlines the plan as a 35Mbps connection with a 3-year contract and unlimited data for up to 6 devices, but no LAN port. The installation fee is 1,500 pesos cash or 100 pesos installment for 18 months. The applicant and property owner must sign to authorize the application.

Uploaded by

nvingua1994
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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BIDA FIBER PLAN APPLICATION FORM

First Name:

Middle Name:

Last Name:

Date of Birth:

Civil Status:

Mothers Full Maiden Name:

Primary Mobile Number:

Secondary Mobile Number:

Email Address:
Alternate Email Address:

House Address:
OWNED ____ RENTED____
Landmark:

Longitude and Latitude:

Household Income:

_____Employed ______ Self-employed


Position:
Company Name:
Company Address:

Plan : BIDA FIBER (35MBPS)


-3 years Contract
-up to 6 gadgets only
-no LAN port available
-unlimited internet

INSTALLATION FEE:

CASH_____(1,500) INSTALLMENT_____(100 pesos for 18 months)


Breakdown: Breakdown:
1,500(cash payment of installation fee) 888 (one month DEPOSIT- to be used at the last month
888 (one month advance) of contract)
TOTAL=2,388.00 TOTAL=888.00

_________________________ Date:___________________
Customer Name and Signature
Date:

Sir/Ma’am,

This is to authorize ,a

resident of , to use my

as a proof of billing for their

BIDA FIBER Internet Application purposes only.

Thank you.

_________________________________ Date:___________________
Owners Printed Name and Signature

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