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Subscription Form Details

This document is a subscription form for a phone plan in another language. It contains the customer's personal details like name, ID, and contact information. It also lists the phone package and plan details including price and commitment period.

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qasim66935
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© © All Rights Reserved
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85 views1 page

Subscription Form Details

This document is a subscription form for a phone plan in another language. It contains the customer's personal details like name, ID, and contact information. It also lists the phone package and plan details including price and commitment period.

Uploaded by

qasim66935
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

Subscription Form ‫طﻠب اﻹﺷﺗراك‬

Contract Number: 1007516817 :‫رﻗﻢ اﻟﻌﻘﺪ‬ Type of Subscription: :‫ﻧﻮع اﻻﺷﺘﺮاك‬

Phone Number: 67631397 :‫رﻗﻢ اﻟﻨﻘﺎل‬ POST VOICE


DD MM YYYY
Date: 21 09 2019 :‫اﻟﺘﺎرﻳﺦ‬ Number Type: VACANT :‫ﻧﻮع اﻟﺮﻗﻢ‬

‫ﺑﻴﺎﻧﺎت اﻟﻌﻤﻴﻞ‬
DD MM YYYY
First Name: Mohammed :‫اﻻﺳﻢ اﻷول‬ Date of Birth: 15 01 1988 :‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬
Middle Name: Mustafa :‫إﺳﻢ اﻷب‬ Nationality: KUWAIT :‫اﻟﺠﻨﺴﻴﺔ‬
Surname: Mohammed :‫إﺳﻢ اﻟﻌﺎﺋﻠﺔ‬ Gender: M :‫اﻟﺠﻨﺲ‬
ID Number: 267010600133 :‫رﻗﻢ اﻟﺒﻄﺎﻗﺔ‬ Other Contact Number: 99185344 :‫رﻗﻢ آﺧﺮ ﻟﻠﻌﻤﻴﻞ‬
ID Type: Civil ID :‫ﻧﻮع اﻟﺒﻄﺎﻗﺔ‬ Email: :‫اﻟﺒﺮﻳﺪ اﻹﻟﻜﺘﺮوﻧﻲ‬
Address: :‫اﻟﻌﻨﻮان‬

KD 15 Package .‫ك‬.‫د‬ ‫ﺑﺎﻗﺔ اﻟـ‬


Package Details: 500 local minutes, 500 local SMS and 50GB of internet. :‫ﺗﻔﺎﺻﻴﻞ اﻟﺒﺎﻗﺔ‬

‫ﺗﻔﺎﺻﻴﻞ اﻟﺨﺪﻣﺔ‬ ‫اﻟﺴﻌﺮ‬ ‫ﻓﺘﺮة اﻻﻟﺘﺰام‬ ‫اﻟﺮﻗﻢ اﻟﺘﺴﻠﺴﻠﻲ‬ ‫رﺳﻮم اﻹﻟﻐﺎء‬


Action Service Details Price Commitment Period Serial No. Penalty Fees

Add iPhone XS Max 256GB Gold 6 353130100451937 38


Add SIM CARD 01 2 040119769585
Add M15 NO-Vanity 24M 0
SWAP TO MONTHLY 15 15 144

I, the undersigned, read and accept the terms and conditions mentioned in the subscription form.

.‫ ﺑﺎﻻﻃﻼع ﻋﻠﻰ اﻟﺸﺮوط و اﻻﺣﻜﺎم اﻟﻤﺬﻛﻮره ﻓﻲ ﻧﻤﻮذج اﻻﺷﺘﺮاك واﻟﻤﻮاﻓﻘﺔ ﻋﻠﻴﻬﺎ‬, ‫أﻗﺮ اﻧﺎ اﻟﻤﻮﻗﻊ ادﻧﺎه‬

Employee Name ABANOUB ABADEER ‫اﺳﻢ اﻟﻤﻮﻇﻒ‬

Date 23/09/2019 ‫اﻟﺘﺎرﻳﺦ‬

Customer Signature Fingerprint Agent Signature

*Please only sign inside the box

SL - F 07
4537962$4757618$1-4

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