To place your order please print out this form, fill it in and return it by fax(1 416 241-5274) or mail.

Your Details
First & last names: _____________________________________________________
Company: _____________________________________________________
Address: _____________________________________________________
_____________________________________________________
City: ___________________________ Post Code:_________________
Phone: _____________________________ Fax:____________________
E-mail: _____________________________________________________
Products Required
Domain name:
Enter the domain name you require. Please also indicate whether this is a new domain or one to be transferred. Enter the domain name fee in the price column;  .ca domain names - $39.00, Top level domain names - $29.00.
Domain name required: ______________________________________________ ($39.00 / $29.00)
New domain or Transfer domain:     Transfer [      ]      New [     ]     
$     -
Account:
Check the type of account you wish to open and choose your billing term. Enter the account fee in the price column.
Domain Parking    [      ] (new domain name registrations only) Free Parking with registration
So Ho Plan           [      ] 50 mb  ($60.00 per quarter / $180.00 per year) Does NOT includes domain or renewal

Enterprise Plan    [      ] 200 mb ($90.00 per quarter / $300 per year)

 Does NOT include domain
Email Anywhere  [      ] 50 mb ( $60 per year) up to 25 email addresses Domain registration extra
Email Anywhere  [      ] 200 mb ( $90 per year) unlimited addresses Domain registration extra
UNIX Shell            [      ] ($45.00 per quarter / $120.00 per year) Great discount, if paid yearly
Co-location          [      ] ($150 per month / $1500 per year) Like 2 month free, if paid yearly
Reseller               [      ] ($99 per month / $1000 per year) Save $ 188 if paid yearly
$     -
(add sales tax of 0% to your total)   GST
 $     -
(calculate the total and enter it in the box provided) Total
$     -
Payment
Payment type:     Cheque [      ]       Credit Card [      ]

If you wish to pay by cheque, please check the relevant box and return the completed form with your cheque. 

If you wish to pay by credit card, please check the relevant box and enter you card details in the spaces provided. We currently only accept Visa and MasterCard.  Return this form to us by post or fax.
Card type: _________________________________________
(Visa or MasterCard Only!)
Card number: ______________________________________

Name on card: _____________________________________
Expiry date: ____________
I agree to abide by Canadian Net's terms and conditions.
Please make cheques payable to 'Canadian Net' and mail with this form to:

Canadian Net
Box 57507
1496 Royal York Road
Toronto, Ontario
Canada M9P 3B5


Tel: 1 800 427 8564
Fax: 416 241-5274
sales@canadian.net
www.canadian.net

Signature: _______________________________________
Name: __________________________________________
Date: ___________________________________________