Registration Form

To arrange to have your services connected please complete the form below 30 days prior to your move-in date. For questions or concerns please call Rogers at 1-866-558-1024.

Current Address:
*Address:
Unit / Suite Number:
City:
Province:	Choose One Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
Postal Code:

New Address:
*Address:
*Community:	Choose One Hullmark 5 Sheppard One Old Mill Two Old Mill Argento Alto and Parkside at Atria
Unit / Suite Number:
City:
Province:	Choose One Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
Postal Code:

Move-in or Occupancy Date:

Important: If you don’t send in the form within 15 days, we’ll assume that you don’t want
cable in your suite and it will be disconnected.

Please note that if you have ordered anything beyond the basic cable service, an appointment
will be scheduled to have a technician visit your home.

1 Offer available for a limited time to customers in homes that have never been wired for Rogers services and subject to change without notice. Free 6 months to customers who subscribe to the listed services. Applies to monthly service fee only. Taxes and additional optional features extra. Regular monthly rates for the applicable services will be charged automatically after the first 6 months unless cancelled earlier. 2 Rogers Anyplace TV Home Edition only available in Ontario to Rogers customers with a My Rogers account, consolidated billing, and select HD digital set top boxes (9865 HDPVR, 8642 HDPVR, 4642 HD, 8300 HDPVR and 4250 HD). Customers must download the Rogers Anyplace TV Home Edition app from applicable app store (free to download). Wireless data charges deducted from usage allowance or at pay per use rate for set/manage/record and remote control features outside of Wi-Fi. Live streaming feature (currently only available on tablets) only available within your home over your own Wi-Fi connection and requires subscription to Hi-Speed Internet (Hybrid Fibre 10 and above) and Rogers Digital TV (excluding Digital Starter Pack) and compatible iPad or Android tablet. Internet usage deducted from your usage allowance or charged at per GB rate for your tier. Live TV content selection is limited. Visit rogers.com/GetAnyplaceTVHome for full details. 3 Based on the Rogers DOCSIS 3.0 network technology current theoretical maximum download speeds of up to 150 Mbps vs Bell DSL network technology current maximum theoretical download speeds of up to 50 Mbps. 4 Certified by SamKnows Limited as of April 2014. Available on the following tiers (download x upload): Hybrid Fibre 10 (10Mbps x 1Mbps), Hybrid Fibre 30 (30Mbps x 5Mbps), Hybrid Fibre 60 (60Mbps x 10Mbps), and Hybrid Fibre 150 (150Mbps x 15Mbps). Tridel®, Tridel Built For Life®, Tridel Built Green. Built For Life.® and Always On® are registered trademarks of Tridel and used under license agreement. ©Tridel 2014. All Rights Reserved. E. & O.E. September 2014. ™Rogers, Mobius design & Live Like Never Before are trademarks of or used under license from Rogers Communications Inc. or an affiliate. © 2014 Rogers Communications.