ENTER YOUR INFORMATION WITH CONFIDENCE – THIS IS A SECURE SERVER!

 

Once you have filled in all your details and submitted the application, you will be contacted on the number you provide on this form. Once contacted and payment has been received, your application will be finalized and processed.

SERVICE PLANS

Naked ADSL

UNLIMITED BANDWIDTH

ADSL Modem

HARDWARE DETAILS (If Required)

ADSL Modem

Delivery

CUSTOMER DETAILS

Name (Required):
Current Email (Required):
Street No: Unit No.
Street Name: Street Type:
Street Direction: City/Town
Province: Postal Code:
Phone (Cell): Phone (Work):
Fax:

PAYMENT DETAILS

Payment Method:



(If paying by cash or cheque, residential customers must pre-pay at least 3 months at a time)
Credit Card:
(We accept Visa, Mastercard and American Express.)
Expiry:
Card or Account Holder Name:
Bank Debit:
(Please enter your 5 digit branch number, 3 digit bank number, and your account number.)

Authorization

Please note that ADSL services are not available in all areas or on all lines due to technical network constraints. There may be special hardware installation required at additional cost in some residences. Please allow a minimum 5 business days for the provisioning of your service. If paying by credit card or bank debit, your card will be auto-debited each month for the subsequent month's access. There is NO CHARGE if we cannot provision ADSL on your line.

I acknowledge that this is a "PREPAID SERVICE" and the first month and hardware sales will be charged today. All monthly fees are payable on or before the 1st of each service month. By filling out the this form you are providing Lightspeed premission to contact you for future communications.

Once an order has been confirmed, it can only be cancelled within 24 hours. Once provisioning and activation is complete the account becomes active immediately and billing commences immediately. Due to technical reasons this cannot be delayed.

* Prices indicated for the various plans do not include applicable taxes, tariffs,$75.00 and $15.00(unless reduced during promotions) set-up fee and the $4.95 per month network access fee. All prices as well as other aspects of our services are subject to change without notice.

To show your acceptance of and willingness to be bound by the terms and conditions listed on our website, please type your name and tick the box "I AGREE" below and click Submit. Click here to view our complete Terms and Conditions.




Your Full Name (Required):