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

Tel: 416-385-0459 Fax: 416-385-0469 Email: sales@eol.ca

VIRTUAL HOSTING SIGN UP FORM

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

Email Redirections

All email to yourcompanyname.xxx will be redirected to the default email account yourcompanyname

Example: email to sales@yourcompanyname.xxx will go to the account yourcompanyname 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 yourcompanyname.xxx	will go to the account	yourcompanyname
Except
Mail for		@yourcompanyname.xxx	will go to the account	yourcompanyname1
Mail for		@yourcompanyname.xxx	will go to the account	yourcompanyname2
Mail for		@yourcompanyname.xxx	will go to the account	yourcompanyname3
Mail for		@yourcompanyname.xxx	will go to the account	yourcompanyname4
Mail for		@yourcompanyname.xxx	will go to the account	yourcompanyname5
Mail for		@yourcompanyname.xxx	will go to the account	yourcompanyname6
Mail for		@yourcompanyname.xxx	will go to the account	yourcompanyname7
Mail for		@yourcompanyname.xxx	will go to the account	yourcompanyname8
Mail for		@yourcompanyname.xxx	will go to the account	yourcompanyname9

* Please Note: If yourcompanyname is more than 13 characters in length the usernames for your email echo-web1 will be the first 13 characters of yourcompanyname.

Please choose a virtual hosting server (select only one):
Unix - Recommended (Apache Web Server with CGI and SSI Capability)
Windows NT (Microsoft IIS Server with Front Page Extensions, ASP and ODBC Database Capabilities)

Additional Services:

Service	Setup Charge	Monthly Charge
MySQL	$10.00	$10.00

Virtual Hosting Price Structure
Initial Setup Fee **	$50.00 CAN	or	$36.00 USD
First Month ***	$25.00 CAN	or	$18.00 USD
Last Month Pre Paid ***	$25.00 CAN	or	$18.00 USD
Total Hosting Fees Due On Sign-up	$100.00 CAN	or	$72.00 USD
Other Charges
Each Additional Month	$25.00 CAN	or	$18.00 USD
* All applicable taxes are extra

This account includes: 10 Personalized Email Addresses, 50MB of Web Storage Space, 500MB of Free Web Transfers & Detailed Traffic Analysis.

** Please Note: This does NOT include domain name registration or transfer fees.

*** Please Note: First and last months hosting fees are pre paid at initial signup.

_____________________		_______________________________________
Date		Signature