GPRS Service Request Form:
(Required fields are marked with
*
)
Sales Partner Information:
*
Company Name:
*
Contact Name:
*
Telephone Number:
*
Email Address:
Customer Information:
*
Company Name:
*
BAN:
*
Contact Name:
*
Telephone Number:
*
Email Address:
Account Information:
Account ID:
User Name:
Password:
Device Information:
PTN
Label
Issue
*
1
No GPS
No Comm
Install Request
Other
2
No GPS
No Comm
Install Request
Other
3
No GPS
No Comm
Install Request
Other
4
No GPS
No Comm
Install Request
Other
5
No GPS
No Comm
Install Request
Other
Other Information:
All Rights Reserved 2004
