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Bravo Telecom

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6001 rue Jean-Talon Est
Montréal, Québec
H1S 1M5

Telephone Montreal
(514) 227-4647

Telephone Quebec
(418) 476-0770

Bravo Telecom

© Bravo Telecom - IT2IS 2018. Tous droits réservés.

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Residential Telecommunication Services - Relocation Form

First name *

Last name *

Ex: AC8888

Account number

Phone number (Main) *

Phone number (Secondary) *

Email *

SECTION : GENERAL INFORMATION

Current address

Civic number *

Street *

App#

City *

Postal code *

New adresse

Please select one of the following elements *

NB: Don’t fill these fields below if you don’t move up. Thank you.

Civic number

Street

App#

City

Postal code

SECTION: SERVICE RELOCATION DATE

Please select three (3) choices of service relocation dates: *

Important

It is important to note that you will need to add 15 days from the moment you select your choice (today) and the moving date. We will try, by all possible means, to get as close as possible to your approximate connection dates.

In addition, you will need to consider that a high number of appointments during the period of June 25th to July 9th will increase the number of waiting days. Please contact our customer service for more information.

You can not choose the same installation date for your three (3) choices

1st service relocation date (approximative)

Date *

Time frame *

2nd service relocation date (approximative)

Date *

Time frame *

3rd service relocation date (approximative)

Date *

Time frame *

SECTION: PACKAGE

Current package *

New package

Subscription type

Monthly subscription (month)

Half-Annual subscription (6 months)

Annual subscription (12 months)

Shipping *

Full installation is only available in Montreal.

Confirmation of all the information before final validation

NB: If you subscribe to a DUO or Bundle packages: You agree, if applicable, to pay additional fees for the material related to the use of these services.

I agree to pay 69.90$ +tx to enjoy my new service plan, plus shipping, if applicable. *

1 + 0 = ? Please prove that you are human by solving the equation *