Affiliate Application

Between DCI Telecom, Box 62, Saint-Laurent, Quebec, H4L 4V4, and the Customer as identified below

Enter your first & last name
Enter your street address
Enter your City, Province & Postal Code
Enter your phone number
Your fax number
Your cellular number
a valid email is required
a "secret code word" to indentify yourself
SIN number for tax purposes

Personal Information Verification (for tax purposes)

Please write your name as it appears on the credit card
Enter your card number.
mm/yy
By providing my SIN and credit card number, I hereby authorize DCI Telecom Inc. and/or its assignee to verify my address and other personal information for tax purposes. DCI Telecom will NOT use this information to charge my credit card.

AFFILIATE TERMS AND CONDITIONS
DCI Telecom Inc., Box 62, St. Laurent, Quebec, Canada, H4L 4V4

By clicking the submit button below, I, the undersigned, confirm that I have read and that I accept the following terms and conditions.

  • DCI reserves the right to approve or reject any Affiliate Program Application in our sole and absolute discretion.
  • You are signing up as a temporary independent contractor, NOT an employee of DCI. As such it will be your responsibility to declare the income you receive from DCI.
  • We pay a one time commission of $50 for any cable Internet activation in Montreal and $100 for any cable Internet & home phone activation in Montreal. Commissions will be paid once a month. There are NO other commissions, even if the customer takes additional services from DCI.
  • You can NOT sign up any existing DCI customers.
  • You can NOT sign up the same person multiple times.
  • You can NOT sign up yourself or anyone living with you at the same address.
  • This is a temporary Affilate contract, designed to boost our Internet and phone service customer base and DCI can terminate your Affiliate status at any time, without prior notice, at the sole discretion of DCI.

  • The terms and conditions of this agreement shall be governed by the laws of the Province of Quebec. It is the express wish of the parties to use the English version of this contract and that this agreement and any directly or indirectly related documents be drawn up in English. Les parties ont exprimé la volonté expresse d’utiliser la version anglaise de ce contrat et que cette convention et tous les documents s'y rattachant directement ou indirectement soient rédigés en anglais.