Credit Card Update

Visa, Master Card, Amex

DCI Telecom, Box 62, Saint-Laurent, Quebec, H4L 4V4
Credit Card Update
Are you applying for residential or business service?
If you checked "business" please list the name here
Enter your first & last name
Enter your street address
a valid email is required
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Credit Card Authorization - (No gift cards, pre-paid cards)
All accounts must be secured with a credit card. Name on card MUST be same as applicant.
We will not charge your card unless your account is overdue or you instruct us to charge your card.
3 digits on back of card
By providing my credit card number, I hereby authorize DCI Telecom Inc. and/or its assignee, to debit the credit card indicated above for all overdue payments or any other amounts ensuing from this agreement, if necessary to do so, for the whole duration of this contract. Each charge shall be treated the same as if I had personally issued a written direction authorizing DCI Telecom Inc. to bill/charge the amount specified to the above-listed credit card account

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 all the above information is true and complete. 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.