Eyesurf - Sign Up

Could not complete sign-up. Please review your order and correct any of the fields in red

Service Address

Street address

Valid street is required

Unit

City

Province

Postal code

Services

Internet package

Phone package

Note: In order to port your number, please ensure the name and address you supply in this sign-up form exactly matches the name & address on your current provider's phone bill.

Keep your number?

Number to transfer

Current phone provider

Note: In order to get ATOP TV service, you must have a Roku Premeire, Roku stick, Apple TV4, or Amazon Firestick. These units are the responsiblity of the customer, and are not provided by Eyesurf

Warning: We strongly recommend at least a speed of 25M in order to have the best possible experience with the TV service. Anything less has been known to cause issues with lagging.

TV package Due to licensing, TV service will only work if subscribed to Eyesurf Internet

Equipment

Modem

Phone adapter (What is this?)

Shipping Address

My shipping address for the modem is the same as the service address

Recepient name

Shipping address

Payment Summary

First bill

Charge description	One-time fee

Regular monthly bill

Charge description	Monthly fee

Contact Details

First name

Last name

Company name (if applicable)

E-mail

Mobile phone #

Alternate phone #

Preferred install time

Communication Preference?

How did you hear of us?

Payment Details

Payment method

Name on card

Card number

Expire month

Expire year

Cvv

Payments typically take 2-3 business days to process. To ensure service is activated as quickly as possible, it is recommended to pay your first bill via credit / debit card, and then you can phone in to switch to online banking payments afterwards. This ensures there will be no processing delays

In order to use this payment method, you need to be registered with one of the following financial institutions: TD Canada Trust, BMO, RBC, Tangerine, CIBC, or Scotia Bank.

We are registered with these institutions as "Eyesurf.net" and "Eyesurf Corp". When making a payment, you will also need to include your customer ID number (CID) which is found at the bottom of your invoice (your invoice will be emailed to you upon submitting this form)

Terms of service

Please note: In order to subscribe to our services, you must agree to our Terms of Service as outlined below by all conditions below

I understand and agree to the Terms & Conditions

Address

Packages

Promos

Contacts

Done

Secure Sign-Up Form