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.

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.


DCI Telecom Inc., Box 62, St. Laurent, Quebec, Canada, H4L 4V4

  • By clicking the submit button below, you, the undersigned, confirm that you have read the present agreement and that you accept the following terms and conditions.
  • You accept that DCI Telecom (DCI) reserves the right to approve or reject any Affiliate Program Application in our sole and absolute discretion.
  • You are signing up as an independent contractor, NOT an employee of DCI. As such it will be your responsibility to declare the income you receive from DCI.
  • Commissions will be credited once a month to your DCI account and paid out when the amount exceeds $100.
  • We pay a monthly commission of $2 if your customer activates cellular service with DCI.
  • We pay a monthly commission of $2 if your customer activates Internet with DCI.
  • We pay a monthly commission of $2 if your customer activates TV service with DCI.
  • You can NOT sign up any existing DCI customers.
  • You can NOT sign up yourself.
  • There are NO other commissions, even if the customer takes additional services from DCI that are not mentioned herein.
  • DCI may prohibit new activations and terminate your Affiliate status at any time, upon 15 days notice, at the sole discretion of DCI. We will continue to provide service to your customers and pay commission to you for any active accounts until said services are no longer available or canceled.

    You are solely responsible for the contents of any advertising or promotional material and shall indemnify, hold harmless and defend DCI, its directors, officers, partnership interest holders, Affiliates, employees and agents from and against any and all losses, damages, expenses, claims, suits and demands of whatsoever nature arising out of or resulting from any advertising or promotional material produced by you.

    CONFIDENTIALTY. You agree to keep all Information received from DCI confidential. You will only disclose or disseminate the Information to your employees, advisors, Affiliates and other representatives who need to know such Information for the purpose of assisting you in marketing DCI products and services. You will be responsible for any breach of this Agreement by your Representatives. This applies to all Confidential Information that is disclosed by DCI to you or that otherwise is learned by or comes into your possession on or subsequent to the date hereof.

    For the purposes of this Agreement, “Information” means any information, conveyed in any manner, media or form including, without limitation, written, graphic, demonstrative, machine recognizable or otherwise, howsoever obtained, which should reasonably be understood to be confidential given the nature of the information and the circumstances surrounding the disclosure, and which may include without limitation technical, financial and business information and models, names of customers or partners (potential or existing), proposed business deals, corporate strategies, cost and pricing data, rates, reports, plans, market and/or financial projections, present or future business plans, activities, products, services, activity, design, process, invention, method, mechanism, know-how, trade secret, intellectual property and other data of or relating to a Party or its Affiliates, together with notes, analyses, work papers, compilations, comparisons, studies or other documents.

    Notwithstanding the termination of the Services, or the relationship between the parties, or this Agreement, (i) the obligations set out herein will continue to apply with respect to Information disclosed; and (ii) this Agreement will continue to apply to any documents, conversation or information in relationship to the Services, the Disclosing Party or its Affiliates, for two (2) years following such date of termination or expiration.

    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.