Applicant's Name Applicant's Name required Name must be minimum 3 words Name must be maximum 100 words Name (in Bengali) Name (in Bengali) required Name must be minimum 3 words Mother's Name Mother's Name required Name must be minimum 3 words Name must be maximum 100 words Father's Name Father's Name required Name must be minimum 3 words Name must be maximum 100 words Mobile Mobile number is required invalid mobile number

Spouse Name Spouse Name required Name must be minimum 3 words Name must be maximum 100 words National ID National ID required invalid National ID number Passport Passport required invalid Passport number Gender Male Female Please select Gender Date of Birth Date of Birth required

House/Plot/Dag No House/Plot/Dag No required Section Section required {{item.Name}} No District matching were found. {{item.Name}} No Thana matching were found.

LANE/Road No LANE/Road No required Block Block required Post Code Post Code required Post Code should be 4 digit E-mail invalid E-mail Telephone invalid Telephone no

House/Plot/Dag No House/Plot/Dag No required LANE/Road No LANE/Road No required Section Section No required Block Block No required Post Code Post Code required Post Code should be 4 digit {{item.Name}} No District matching were found. {{item.Name}} No Thana matching were found.

{{item.Name}} No Zone matching were found. {{item.Name}} No Division matching were found. {{item.Name}} No Area matching were found. E-mail invalid Email number Telephone invalid Telephone number Mobile Mobile number is required invalid mobile number

Connection Type Temporary Permanent Select Connection Type {{item.Name}} ({{item.Tariff}}) No Catagory matching were found. Organization/Shop Name Organization/Shop Name required

Phase Single Three Select Phase No. of Meter No. of Meter required Demad Load per Meter in Kilowatt Please servay Load 1st