To protect your privacy and personal information this page is on a secure server.

To order your new phone and rate plan simply fill out the form below then click on the "Print" button in your browser. It then needs to be faxed to us at (519) 336-5726. If you do not have direct access to a fax machine many local convenience stores have fax machines available for use as well as postal outlets and places like Business Depot/Staples. We will contact you once we receive your fax and go over any details or questions. Feel free to contact us if you have any questions before faxing in your Service Agreement.

TELUS Mobility Service Agreement

BILLING INFORMATION - Person who will be responsible for the payment of the account
INDIVIDUAL OR SOLE PROPRIETOR
OR
LIMITED OR INCORPORATED BUSINESS
Last Name
Company Name
First Name
Attention
Address
Suite/Apt.
City
Province
Postal Code
Email
CREDIT INFORMATION - (minimum of 2 pieces of ID required)
INDIVIDUAL OR SOLE PROPRIETOR
OR
LIMITED OR INCORPORATED BUSINESS
Home Tel. No.
Business Tel. No.
Birthdate (MM / DD / YY)
Main Business Tel. No.
Director/Principal
Nature of Business
Address of Head Office
Business Registration No.
Business Incorporation Date
Social Insurance Number (S.I.N.) - optional
Drivers License No.
Expiry Date
Photo Verified
Credit Card Info
American Express
Mastercard
Visa
Yes, I wish to have my credit card debited for monthly payment on my TELUS Mobility Account
Credit Card Number
Expiry Date (MM / YY)
WIRELESS PHONE INFORMATION
RATE PLAN
Name of Rate Plan
CONTRACT TERM
1 Year
2 Year
3 Year