Maya Cyber World
User Registration Form
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User Information
Name of Applicant: *
Date of Birth *
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Address: *
Contact Number: *
Email: *
Attachment (If any One): *
NID, Passport or Student ID Number (Any of One): *
Reference(If any)
Technical Information:
If you are already one of our user, all of the information down below has to be filled. (Comment is optional)
Connection Type:
Clear selection
Package (Internet Bandwidth):
PPPoE UserName:
MAC Address:
Conn Establish Date:
MM
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DD
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YYYY
Comment
Submit
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