If you are unsure or don't have one then please select: I DON'T KNOW
Don't worry, if you don't have one or cannot access now please select 'No' and proceed.
Please enter your WORK email address based on the above choice.
Please enter your PERSONAL email address
How you heard about us?
I agree to receiving occasional promotional emails. You can unsubscribe at anytime when receiving any special promotional email.
Please refer to the instructions above and input the 8 character discount passcode once you have received it.
Acceptable forms of employment verification are: Employee ID Badge, Pay Stub, Letter of Employment on company letterhead, etc. The document must show your legal name that matches your government issued ID and the name of your organization.
*Some promotional plans are not available for price plan changes only. We may have creative options for you so please discuss with our team after submitting this form
Enter your legal name as it appears on your ID
Please enter your primary mobile phone number that you want to move to Rogers or from your existing Rogers account. Number MUST start with 1 and contain only numbers. Example: 16045551234
The mailing address for your new account or existing Rogers Account
Please enter the 4 digit PIN you would like on your account or have on your existing Rogers account. If you do not want a PIN or do not have a PIN, leave this blank
Please enter your Employee Number. If you do not have one type N/A
Please attach a picture of your Driver's License. If you do not have a driver's license please attach another Canadian government issued ID. Health cards are not accepted.
Please select one. If you are uncomfortable sharing on this secure form, please select the first choice and type "call me"
Please enter your SIN Number
Enter your 16 digit credit card number without spaces
Enter your 15 digit Amex number
Credit Card Expiry Month
Credit Card Expiry Year
Please enter your complete provincial ID Number
Which province your provincial ID was issued in?
Please enter your Candian Passport Number. Non-Canadian Passports are not accepted.
Please choose a plan that you're interested in. This is not the final plan choice for your account.
Please add any additional details for your request here
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