2600 Skymark Ave.
Buklding 9, Suite 201
Mississauga, Ontario
L4W 5B2
Tel: 416-385-0459
Fax: 416-385-0469
Email: sales@eol.ca

INTERNET PRIMER SIGNUP FORM

Company Name: __________________________________________


Company Address: __________________________________________
Unit/Suite: __________________________________________
City: __________________________________________
Postal Code: __________________________________________

Contact Name: __________________________________________
Contact Phone: ________________ Contact Fax: ________________
  
Business Name: __________________________________________
(maximum 13 characters lowercase alphanumeric only)


Email Redirections

All email to yourbusiness.corp.eol.ca will be redirected to the default email account yourbusiness

Example: email to sales@yourbusiness.corp.eol.ca will go to the account yourbusiness unless you specifically specify otherwise.

Below is a listing of email addresses that you do not want to go to the default email account.

Remember: Do not specify names that you wish to go to the default email account.

ALL MAIL for yourbusiness.corp.eol.ca will go to the account yourbusiness
Except
Mail for
@yourbusiness.corp.eol.ca will go to the account yourbusiness1
Mail for
@yourbusiness.corp.eol.ca will go to the account yourbusiness2
Mail for
@yourbusiness.corp.eol.ca will go to the account yourbusiness3
Mail for
@yourbusiness.corp.eol.ca will go to the account yourbusiness4
Mail for
@yourbusiness.corp.eol.ca will go to the account yourbusiness5
Mail for
@yourbusiness.corp.eol.ca will go to the account yourbusiness6
Mail for
@yourbusiness.corp.eol.ca will go to the account yourbusiness7
Mail for
@yourbusiness.corp.eol.ca will go to the account yourbusiness8
Mail for
@yourbusiness.corp.eol.ca will go to the account yourbusiness9


Internet Primer Price Structure

28.8/33.6/56K 64K ISDN * Includes 350 Hours of Internet Access
Initial Setup Fee $49.99 $49.99 * Additional Hours $0.50
First Month $59.99 $79.99 * Total of 10 Email Addresses
Each Additional Month $59.99 $79.99 * Includes Basic Web Hosting
* All applicable taxes are extra

_____________________ _______________________________________
Date Signature

Payment can be made via VISA, Mastercard, American Express or cheque. Please make all cheques payable to Echo Online Internet.