604-288-1089
Cable Internet Form
Available in BC, Alberta and Manitoba - Unlimited Data Usage, No Contracts, Friendly Live Support
Transferring from existing cable or DSL? Get FREE activation – Contact us for details!
SERVICE ADDRESS
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| Unit Type | Unit Number | ||
| Street Address | |||
| City | |||
| Province | Postal Code | ||
| Country | |||
CABLE INTERNET SERVICE
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AVAILABLE MODEM(S)
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SETUP / INSTALLATION
Installation Type
Preffered Installation Dates
#1 Choice
#2 Choice
#3 Choice
Outlet Location
COVID-19 Pre-Screening Information (Required)
| 1 Are you experiencing any COVID-19 symptoms, such as fever, new or worsening cough, shortness of breath or difficulty breathing? |
|
| 2 Do you believe you have come in contact with someone experiencing COVID-19 symptoms? Or have you been contacted by Public Health or a business about a positive COVID-19 case? |
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| 3 Have you travelled internationally in the last 14 days or come into close contact with anyone who has? |
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PERSONAL INFORMATION
Firstname
Lastname
Company
Email Address
Phone #
SERVICE ADDRESS
Unit / Apt.
Unit #
Street #
Street Name
City
Province
Postal
Agent Code
Internet Service Provider (ISP)
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Questions or having trouble? Call us during regular office hours at:
866-286-0894
AEBC Office Hours:
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9:00AM - 5:30PM
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