| Web Profile Identification |
| Web Profile Description (for your own use) |
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| Web Profile Administrator |
| First Name |
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| Last Name |
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| Administrator's E-mail Address |
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User Name
(Your user name is used to log into Spectrum Direct.) |
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Password
(Must begin with a letter, can contain only letters and numbers, minimum 6 characters) |
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| Confirm Password |
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| Industry Canada Service Centre |
| Please select the Industry Canada service centre (office) that will receive this account request and the licence applications that you submit with it. We will use the geographic information you provide to create accounts in other service centres if required. You will submit future licence applications directly to those service centers. |
| Industry Canada Service Centre |
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| Please indicate all geographic areas in which you intend to install and operate your first radio systems (e.g., municipality, region, province, nation-wide, etc.) |
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| Licensee Information |
| Licensee Name (legal name of an individual or an incorporated company) |
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| Licensee Type |
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| Describe the intended use of your radio systems (e.g., taxi, construction, etc.) |
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| Address |
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| City/Town |
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| Canadian address? |
Yes No |
| For addresses within Canada: |
Province |
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Postal Code |
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| For addresses outside of Canada: |
Country |
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ZIP or postal code |
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| Home Phone (999)999-9999 |
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| Work Phone (999)999-9999 |
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Ext. |
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| Fax Number (999)999-9999 |
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| Licensee's E-mail Address |
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| Preferred Language of Correspondance |
English French |
| Special Requirements |
| Additional Information (any special requirements, such as additional account options, etc. For a business, include other operating names. If the licensee is incorporated, please provide the date and jurisdiction of incorporation.) |
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| By submitting this form, I hereby request to be issued an account with Industry Canada for the purposes of holding a radio licence as a radiocommunication user or radiocommunication service provider. I meet the eligibility requirements for holding a radio licence as specified in the Radiocommunication Regulations, Part I, 9(1). |
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Request New Account and Web Profile
Account Details
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