Sussex Application Form

Account Information

Contact Information

Product & Service Information

Please enter any existing telephone/fax numbers you wish to be associated with your new service (if any)

Other Services

I am also interested in the following services:

Payment Options

A void cheque must be faxed to our office before your new account can be setup.

Fax to: 613-727-3317 or 877-898-7859

Please call me to get my credit card information (We will use your contact number.)

Terms & Conditions

Terms and Conditions for Sussex Telecom Inc. Services:

I, the Customer, hereby apply to Sussex Telecom Inc. under the terms and conditions in this application. I have read these terms and agree to be bound by them. Sussex Telecom Inc. may make credit inquiries at any time regarding my application. This information is confidential and will be used for the sole purpose of approval and administration of my account. Overdue accounts are charged 1.5% interest per month. I authorize Sussex Telecom Inc. to charge my credit card or debit my account for all outstanding invoices that are past due. This authorization shall continue until the total amount owing, including interest, has been collected. Declined payments will result in a $25.00 Service Charge, and may result in interruption or termination of service(s). Rates are subject to change without notice.

Direct Dial Long Distance (When retaining existing telephone service)

My signature below authorizes Sussex Telecom Inc. as my Agent, to notify the local telephone company of my decision to choose Sussex Telecom Inc. services for Equal Ease of Access. Equal Ease of Access means when I direct dial a long distance phone number, the call will automatically be carried by a carrier of Sussex Telecom Inc.'s choice. By choosing this option, I agree to subscribe the above telephone, facsimile and/or modem numbers to Sussex Telecom Inc.

ELITE Long Distance

By adding the ELITE Long Distance Plans to your cellular phone, Sussex Telecom Inc. provides the Long Distance ONLY. Any additional charges from your cellular carrier that may incur and not limited to roaming, airtime or exceeding local minutes provided by your cell plan are your responsibility. Please consult your cellular carrier before traveling or if any of these charges are applied to your account. "Caller Block ID" must be turned off prior to activating ELITE Long Distance, unless you wish to use a PIN as your means of authorisation.

Sussex Telecom Inc. VoIP

VoIP service is dependent on the customer having high speed internet access. VoIP customers will be notified with installation instructions. Sussex Telecom Inc. VoIP 911 service is available but limited. Important information regarding the 911 limitations is shown here and will also be sent to you after you sign up for one of our VoIP services. YOU MUST READ AND UNDERSTAND THE SUSSEX VOIP 911 POLICY BEFORE YOU SIGN UP FOR VOIP SERVICE. Numbers (DID's) may be subject to a minimum time period commitment, depending on volume.

Adapters & Other Hardware

The HomePHONE Phone or Business Line adapter is the property of Sussex Telecom Inc., unless it was purchased under the Basic Plan; please return if your service is canceled; you may buy the adapter for your personal use, and your account will be billed $99.

Notice About Dry Loops

If you currently have DSL internet service RUNNING ON YOUR PHONE LINE, from ANY provider, it is critical that you contact that provider to let them know that you wish to retain your existing internet. They may have to install a special line, called a "dry loop". Failure to advise them that you want to keep your internet after the existing number is ported over to Sussex Telecom Inc., may mean that you will lose the internet service after the port has been completed. This does not apply to cable or wireless internet service.

I have read and agree to the terms and conditions.

Your Privacy Matters

This page is encrypted with 256-bit SSL using SHA1 RSA (2048 bit). All information contained herein is meant only for the sign-up process. Your information will never be sold or traded. We will never reveal any information except where required to by law with proper court order.

You can always call us with the number below to sign-up over the phone.