You may use the following form to register as a partner of the Telusys Customer Service Center. TCSC account activation is subject to verification for both new and existing Telusys clients. Please register by submiting the following form.


  EXISTING TELUSYS CLIENT INFORMATION

  *Are you an existing Telusys client?   Yes       No

Please enter the following user name and password information only if you are an existing Telusys client.
Existing User Name:
Existing Password:





  ACCOUNT CONTACT INFORMATION

 
*First Name:
*Last Name:
*Title:

*Company/Organization:
*Address 1:
Address 2:
*City:
 State/Canadian Province:
International Province:
Zip/Postal Code:
*Country:

*Phone:
*Fax:

*E-mail Address:

  *Required Fields  




  PAYMENT MAILING ADDRESS


  Please indicate the address where Telusys should mail payments.

*First Name:
*Last Name:
*Title:

*Company/Organization:
*Address 1:
Address 2:
*City:
 State/Canadian Province:
International Province:
Zip/Postal Code:
*Country:

*Make Checks Payable To:

  *Required Fields  




  SELECT A USER NAME AND PASSWORD


Use the input fields below to assign yourself a user name and a password. User names and password must be unique, they should be at least 6 characters long and no more than 20 characters long. User names and password are case-sensitive and must only be comprised of the letters "a" to "z" and the numbers "0" to "9". All passwords must contain at least one numeric digit for security purposes. Users are strongly discouraged from using any word that would appear in a dictionary as their user name or password.

*User Name:
*Password:
*Confirm Password:





  DIGITAL SIGNATURE

By signing below, the client acknowledges that they have read and understand the terms and conditions in this agreement and agree to be bound by the Terms and Conditions of this agreement.
I have read the Terms and Conditions and accept them in their entirety.
Signature:




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