Previous Street Address (if at above address for less than 2 years)
Postal Address (if different to above)
If you are an individual we will collect personal information about you. Clause 7 of the Standard Customer Agreement contain provisions about the use by TELEUS of your personal information. A summary of clause 7 of the Standard Customer Agreement is set out in the Summary provided with this Application. You should also read the provisions in the Standard Customer Agreement. By signing this Application you confirm that you have read and understood and you agree to those provisions.
If you would prefer that we do not use your personal information for direct marketing purposes, please tick this box (see clause 7.2(e) of the Standard Customer Agreement, a summary of which is set out in the Summary provided with this Application, for the way in which we will use your personal information if you do not tick this box).