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Internet Connection Request Form

This document is a registration form for internet, Wi-Fi, and IP phone services from the Local Government Engineering Department. It requires personal and office details, including contact information and computer specifications. The form also includes a disclaimer stating that the IP owner is responsible for any misuse related to government or country activities.

Uploaded by

masuddhk
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© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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96 views1 page

Internet Connection Request Form

This document is a registration form for internet, Wi-Fi, and IP phone services from the Local Government Engineering Department. It requires personal and office details, including contact information and computer specifications. The form also includes a disclaimer stating that the IP owner is responsible for any misuse related to government or country activities.

Uploaded by

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

Local Government Engineering Department

Internet / Wi-Fi / IP Phone


Registration Form
Date:

1. Name : ………………………………………………………………………………………
2. Designation : ………………………………………………………………………………………
3. Office/Project/Unit : ………………………………………………………………………………………

4. Building a. (i) LGED (ii) RDEC (iii) Workshop

(iv) Dhaka Division (v) Dhaka Division (LKSS HRC)

b. Level

5. Contact i. Telephone

ii. Mobile

iii. Intercom

iv. IP Intercom

6. Computer Description (only for desktop connection):


Computer Name:
Processor:
HDD:
RAM:
OS:
Anti-Virus:

Applicant’s Signature & Date Recommended By


(Unit Head/PD)

---------------------------------------------------------OFFICE USE ONLY---------------------------------------------------

7. MAC Address - - - - -

8. IP Address . . . User ID: Password:

Signature of
Unit in Charge

Condition: As the IP of internet connection will be used as official purpose, therefore, using this IP any email, messages,
content or any social media post against Government, country or any destructive activity related to country will be the
liability of this IP owner.

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