ROGERS PREFERRED PROGRAM - Planete Mobile

PLANÈTE MOBILE | ROGERS CORPORATE REBATE ADMISSIBILITY REQUEST FORM.

The information requested in this form is necessary in order to provide you with pertinent information relevant to the company or government sector you work for. This information will enable you to access your corporate discount and any promotions available on our online ordering website.

Do you work for a Government Organization*
- YES
- NO
What Field
Other

Please specify
Department and/or Ministry

This will enable us to efficiently provide you with information regarding your request.
Do you work for a Large Corporation*
- YES
- NO
Name of the Company
Actual Provider*
Other

Please specify
Name*
First Last
Phone*
Province*
Please note that proof of employment is necessary to be approved for the corporate rebate.

If possible, provide us with your corporate email address as it is an approved proof of employment.
Email*
Corporate Email
Personal Email
*Proof of employment will be required when placing your order

Acceptable proofs of employment:
Corporate email
Paystub
Identification card with picture
Letter of employment from human ressources
By completing this form, you consent to being contacted regarding your discount admissibility request.*
- I agree
- I disagree
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- Interested
- Not interested
Name
This field is for validation purposes and should be left unchanged.