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Name
Tel. Number
Address
City
Email Address
Service type
Dial Up Broadband
Provider
DIL
BSNL
SIFY
TATA
Other
Are you satisfied for present provider’s services or u wants to Change: - Satisfied Change
What you are looking
Better Rates Better Services
Do you think Dialup is most easy and economical internet service: - Yes No
How you will rate DIL Dialup Prices
High Normal Low
Which Telephone connection you have
Wired WLL
Of Whom
RAINBOW
RELIANCE
Valuable suggestions/ Complaint/information