2600 Skymark Ave. Building 9, Suite 201 Mississauga, Ontario L4W 5B2

Tel: 416-385-0459 Fax: 416-385-0469 Email: sales@echo-on.net

DOMAIN NAME SIGN-UP FORM

Company Name:	__________________________________________
Company Address:	__________________________________________ __________________________________________
City:	__________________________________________
Postal Code:	__________________________________________
Contact Name:	__________________________________________
Contact Phone:	________________ Contact Fax: ________________
E-Mail Address:	__________________________________________

Domain Name

If your domain name is already registered with Echo Online server values please choose activation as the sign-up type.

Please Indicate Sign-up Type.
     New Domain Name Registration,  Domain Name Transfer or  Domain Name Activation

If the domain is registered but does not have Echo Online server values please fill in
the following fields:

Domain Registrar:______________________________________________________
Domain ID:___________________________________________________________
Domain Password:_____________________________________________________

Fees For New Registerations

Domain Name Sign-up Price Structure	CAN	USD	Includes:
.com .net .org Domain Name Sign-up	$75.00	$50.00	* 2 Year Registration/transfer paper work
.ca Domain Name Sign-up	$100.00	$66.00	* Domain name addition to our servers

Fees For Domain Renewals

.com .net .org Renewals	$40.00	$25.00	* 1 Year Renewal/transfer paper work
.ca Renewals	$50.00	$35.00	* 1 Year Renewal/transfer paper work

Please Note:
* Customer is responsible for paying registration fee to respective organizations.
* Does not include virtual host or dedicated connection setup fee

Please See: Virtual Hosting sign-up sheet for additional Virtual Hosting options and charges.

_____________________		_______________________________________
Date		Signature

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