Get Optional Top-up Enrollment Form - Esports Desk

Filling out the Optional Top-Up Enrollment Form for the ESports Desk can seem daunting, but with clear guidance, you can complete it efficiently. This guide will walk you through each section of the form, ensuring you understand what information is needed and how to provide it correctly.

Follow the steps to complete the enrollment form successfully.

1. Press the ‘Get Form’ button to obtain the form, making sure to have it open in an online editor or form tool.
2. Fill out the applicant information section by entering your title, last name, first name, and date of birth in the specified format (DD/MM/YY). Ensure you indicate your gender as either male or female and provide a middle initial if applicable.
3. Next, provide your complete mailing address including home address, city, province, and postal code. Ensure that all mandatory fields marked with an asterisk (*) are filled out.
4. Enter your telephone number and email address in the designated fields.
5. In the plan and coverage section, select the options applicable to you, such as Accidental Medical Reimbursement. Specify whether you are a minor member or another member, and calculate the total premium, including applicable tax for your province.
6. Choose your premium payment option: either credit card or pre-authorized debit. If selecting credit card, fill in the required details like card type, number, expiry date, and cardholder's signature. If opting for pre-authorized debit, ensure you attach a void cheque and provide the necessary authorizations.
7. Read the authorization for use of your personal information and privacy notice thoroughly. Indicate if you do not wish your personal information to be used for additional products or services.
8. Complete the declaration and authorization section by signing and dating the form, ensuring all information is true to your knowledge.
9. Finally, save your changes to the form, download a copy for your records, and print or share the completed form as needed.

Begin your enrollment process by completing the Optional Top-Up Enrollment Form online.