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Order Cable-Internet

Your Contact Information:
First Name:
Last Name:
E-mail Address:
Your Phone Number: Format: 123-456-7890

Your Service Address:
Street Number:
Street Name:
Suite/Unit/Apt:
City:
Province:   Ontario
Postal Code:

Choose Your Service Plan:


    Cable-C15
    Cable-C60
      Cable-C120

  Add StaticDNSIP

Equipment Options:

  Supply Your Own Equipment
    Buy Modem/Router/WiFi Unit
Installation Options:

  New Installation
  Transfer Service

Credit Card Information:
Name on Credit Card:
Credit Card Number:
Credit Card Expiry Date:
Credit Card CCV:

Special Instructions or Additional Information:


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