Request for New Connection

Please note: fields marked by are required.(*)

Name of the Institution *

Address of the Institution *

Location where connectivity is required *

Same as Address

State*

District *

City *

Number of Users *

Number of Nodes *

Request for Bandwidth *

Existing IT Infrastructure *

Name of Contact Person *

Official Landline *

Mobile *

Official Email Address *

Research Projects (PDF, max 500KB)

Letter from Head of Institution (PDF, max 500KB)