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Personal Information
Full Name / Company Name   *   CPR No/CR No.   *
Nationality     Date of Birth *  
Postal Address     Telephone Number   *
  Fax Number  
  E - mail Address   *
  City  
  Country  
Etisl Service Information
Etisl Package     Do you require a Linksys PAP2  
        Do you require a IP Phone  
        Do you require a Mobile Dialer   Free
        PC / Laptop Softphone  
Phone Number Information
Desired Etisl Phone Number
eg. 97313301330
    Include Number in Directory