New Internet Leased Line Please enable JavaScript in your browser to complete this form.Fields marked with an * are required If you would like to apply for Leased Line, please fill in your details in this Form below and you will be automatically notified by our Representatives. Should our Agents / Representatives fail to reply to your request, please call us at our toll free number 1600. Please ensure that the fields marked in asterisk(*) are filled,ticked or chosen.Customer DetailsName(Individual/Organization) *Select dzongkhag *ZhemgangSamdrup JongkharPemagatshelMongar Trashigang Trashi YangtsheLhuentseBumthang TrongsaSamtseTsirangWangdue PhodrangGasaPunakha Dagana ChukhaGelephuHaaThimphu ParoLocation (exact location) *CID (if individual) *Contact No: *Email Address *Choose your choice of bandwidth (minimum bandwidth to be subscribed: 2Mbps) *One time annual charge of Nu.300 for IP address shall be applicable.*The installation charge of Nu. 2,500 shall be applicable *The shifting charge of Nu. 2,500 shall be applicable *The Media Converter charge shall be applicable *Router / Switch is required.*For pricing on router and switches please contact nearest BT office or call 1600 Application Date *(Effort is made to perform installations in a timely manner, however please note that installations will be made on a first-come-first served basis) Service can be activated any day of the month, billing shall commence from the day of activation DeclarationI hereby agree to the terms and conditions laid down on the agreement form Terms & Conditions Upload a ID copy of applicant * Click or drag a file to this area to upload. Upload a ID copy of surety * Click or drag a file to this area to upload. Upload scanned copy of Leased Line Application form * Click or drag a file to this area to upload. Upload Scanned Copy of LL Surety Form * Click or drag a file to this area to upload. Others: A copy of license or relevant documents Click or drag a file to this area to upload. Application must be submitted with mandatory documents (stated above). Failure to do so will mean rejection of your application. I agree terms and condition I AGREE TERMS AND CONDITIONSSubmit Get in Touch with us (+975) 343434 Toll Free: 1600 Address: Drophen Lam 2/28, Chubachu Thimphu, Bhutan