Web Hosting Application Form - for Vancouver Internet

Web Hosting Application

(Click here for web hosting options and promotion, or here for the domain name registrations.)

Vancouver Internet will place your web site "live" on our servers so the whole world can view your web site anytime anywhere. We include scheduled tape backup and anti-virus scans, power backup, 50MB storage per site, redundant servers, full 7/24 FTP or FrontPage access, CGI, Perl and PHP support, at least 5X free email addresses and more. We transfer or setup your domain name and email address at no charge and you can be "up and running" within 24 hours, with no down time.

W1 - Standard web hosting package for $20/month
W2 - Standard web hosting package plus a secure page for $35/month
W3 - High bandwidth web hosting (call/email Vancouver Internet for quote)

Web Page Details
URL Name:	http://www.
Domain Type:
optional (Brief company description):
Login Username:	(name and password required
Login Password:	for any web page updates)
Billing Information
First Name:
Last Name:
Organization Name:
Street Address:
optional (eg: Suite #245):
optional Address 3:
City:
Province or State:	(Canada, or US use two char abbr.)
Country:
Postal Code:
Phone Number:	(eg. 604-555-1122 x333)
optional Fax Number:	(eg. 604-555-1122)
Email:
Options
Hosting Package:
Email Package:
Payment Method:
Comments or Instructions:
Thank you. Your web hosting application will be processed immediately. Vancouver Internet Inc. Email: info@vancouverinternet.com Call: (206) 201-2784 Revised: March 2008
Payment Details
Payment Method:	For easy payment options goto http://www.vancouverinternet.com/Apply