Protection Plan

Information about the parent responsible for the cell phone account
First and Last Name
Address
City
Postal Code
Cell Phone #

Information about the teen, aged 18 years old or less
First and Last Name
Age
Status	Student Part-Time Worker Full-Time Worker Other

Please include your email addresses to receive special offers from NorthernTel Mobility (your addresses will not be shared with a third party):
Your email address
Your teen's email address

† Your authorized dealer will require a proof of age.

The free subscription to the WirelessCare Maintenance Plan will apply directly to the new client’s (aged 18 years old or less) postpaid account for the term of the contract as soon as the completed form is received within 30 days of the beginning of the new subscription. Offer subject to change without prior notice. For more information, contact NorthernTel Mobility’s Customer Service Department or an authorized NorthernTel Mobility dealer.