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Residential and Business High Speed Internet Order Form


  • Order Form
    Activation Phone Number or
    Naked DSL/Dry Loop: *
      
    DSL TYPE: *
    DSL Term: *
    Ship DSL Modem? *
    Local Phone Provider: *
    Company:
    First Name: *
    Last Name: *
    Work Phone:
    Home Phone #: *

    Billing Information

    Street Number: *
    Street Name: *
    Street Type: *
    Buzzer Code #:
    Apartment Number:
    City: *
    Province: *
    Postal Code: *
    Country: *
    E-mail Address: *

    Credit Card Information


    Name on Credit card: *
    Credit Card Number: *
    Credit Card Expiration Date *

    Account Security

    Security Password(Optional)

    Installation Instruction

    Preferred time of the day *

    Preferred date:(YYYY-mm-dd):

    Generally DSL activation takes 5-7 business day from today
    Additional Comments
    How did you find us:

     

Our Commitment

30 Day Money Back Guarantee

We pride ourselves on getting things done right. That doesn't mean we are perfect, but when we make mistakes we fix them.

If we can't fix them to your liking and you're not 100% satisfied with your purchase of Acanac's High Speed Internet Service you may cancel the service within 30 days of activation. We will offer you a complete refund of the fees and taxes you paid for the service minus your modem purchase, activation fee and shipping fee.

Currency
All prices are in Canadian Dollars.


Price breakdown:



Credit Card