Internet Bundle Order Form    Unlimited Internet (No Cap)
Active Phone line number or Dry Loop: *   
Plan TYPE: *
Plan Term: *
DSL/FTTN/Cable Modem? *
Do You Have Internet: *
Name Service Provider:
Type of Service:
Customer Information
First Name: *
Last Name: *
Work Phone:
Mobile/Home Phone #: *
E-mail Address: *
Street Number: *
Street Name: *
Property Type: *
Buzzer Code #:
Apartment Number:
City: *
Province: *
Postal Code: *
Country:
Credit Card Information
Credit Card Type: *
Name on Credit card: *
Credit Card Number: *
Expiry Date *
CSV (Optional):
Agent (Reseller)
Reseller Name:
Business Name:
Location/Address:

Installation Date (Minimum. 5 Business Days)
Preferred time of the day *

Preferred date:(YYYY-mm-dd): Pick a date
Additional Comments
How did you find us:

Our Commitment

PHP Money Back Guarantee

Currency
All prices are in Canadian Dollars.


Price breakdown:

 

Item Term Monthly fee Total for term $CAD
Ont-FTTN 15M-UL 1 Month Term 44.95 44.95
Modem fee One time One time 49
Activation Fee One time One time 49.95
Shipping fee One time One time 9.95
Final Price Tax 21.04
Total $CAD 182.89

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