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Registration
High Speed Service Information
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Preferred Userid:
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Preferred Password:
Billing Information
First Name:
Last Name:
Address:
Unit/Suit/Apartment #:
City:
Province:
Ontario
Quebec
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Postal Code:
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Current E-mail:
Payment Information
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Choose payment type:
by Cheque
by Online Banking
by Credit Card
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Credit Card Holder Name:
Credit Card Type:
DISCOVER
MASTERCARD
SEARS
VISA
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Credit Card Number:
Expiration Date:
01
02
03
04
05
06
07
08
09
10
11
12
/
06
07
08
09
10
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12
13
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20
MM/YY
Order Placed By:
Comments/Questions:
Bank:
BANK OF MONTREAL
CIBC
Desjardins
Hongkong and Shanghai Banking Corporation
Meridian Credit Union
National Bank
President's Choice
Royal Bank
Scotiabank
TD CANADA TRUST
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