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

DIAL-UP ACCESS SIGN UP FORM

Name: __________________________________________
Address: __________________________________________
Apt./Unit: __________________________________________
City: ____________________
Postal Code: ______________
Phone Number: (_____) ______-__________
Fax Number: (_____) ______-__________

Dial-up Account Listing

New User Special - $8.33/mth paid yearly Term Price Setup Tax Total  
Unlimited Interactive Access
1 E-mail Address, 10 MB Web Storage Space
12 mths $99.99 N/A $7.00 $106.99
Yearly Super Special - $12.50/mth paid yearly Term Price Setup Tax Total  
Unlimited Interactive Access
2 E-mail Address, 20 MB Web Storage Space
12 mths $150.00 N/A $10.50 $160.50
Easy-Mail - $5.00/mth Term Price Setup Tax Total  
15 Hours Per Month
Additional Hours: $1.00/hour
1 E-mail Address, 5 MB Web Storage Space
2 mths* $10.00 $25.00 $2.45 $37.45
3 mths $15.00 $25.00 $2.80 $42.80
12 mths $60.00 $25.00 $5.95 $90.95
Comm-Lite - $8.29/mth paid yearly $9.95/mth paid quarterly Term Price Setup Tax Total  
50 Hours Per Month
Additional Hours: $1.00/hour
1 E-mail Address, 10 MB Web Storage Space
3 mths $29.85 $25.00 $3.84 $58.69
12 mths $99.50 $25.00 $8.72 $133.22
Comm-Plus - $12.50/mth paid yearly $14.95/mth paid quarterly Term Price Setup Tax Total  
100 Hours Per Month
Additional Hours: $0.50/hour
2 E-mail Address, 10 MB Web Storage Space
2 mths* $29.90 $25.00 $3.84 $58.74
3 mths $44.85 $25.00 $4.89 $74.74
12 mths $149.99 $25.00 $12.25 $187.24
Bronze - $16.67/mth paid yearly $19.99/mth paid quarterly Term Price Setup Tax Total  
150 Hours Per Month
Additional Hours: $0.50/hour
5 E-mail Address, 20 MB Web Storage Space
2 mths* $39.98 $25.00 $4.56 $69.54
3 mths $59.97 $25.00 $5.95 $90.94
12 mths $199.99 $25.00 $15.75 $240.74
Communicator - $19.99/mth paid yearly $19.99/mth paid monthly Term Price Setup Tax Total  
**Unlimited Access
4 E-mail Address, 20 MB Web Storage Space
2 mths* $51.98 $25.00 $5.39 $82.37
3 mths $77.97 $25.00 $7.21 $110.18
12 mths $239.99 $25.00 $18.55 $283.54
* First and last month due on signup.
** Some conditions apply.



Preference

Preference Login Name Instructions
1st Choice
Login names can be from 3-8 character. All character must be lower case. Valid character are any Alpha Numeric Characters (a-z,0-9). Punctuation is Not allowed. Usernames must begin with a letter.
2nd choice
Password
7-16 Characters. NO punctuation allowed. Passwords must contain atleast 5 letters and 2 or more numbers. The letters must consist of both upper and lower case characters. Example: 5Hshq6G

Payment Information

Visa MasterCard American Express Check/Money Order Other


Credit Card Number:__________-__________-__________-__________ Expiry:_____/_____

Name as it appears on the Credit Card:___________________________________________

Please automatically bill my credit card monthly on the account renewal date Yes / No

I authorise Echo Online Internet Inc. to process a monthly debit, in paper, electronically, or any other form on my credit card in the amount necessary to render my account with Echo Online Internet Inc. to a positive balance.

I understand that written notice must be received by Echo Online Internet Inc. in order to terminate this agreement.

Cardholders Signature:________________________________________________________

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