Order - Basic Website Hosting

Before you begin:

Please complete this form fully. When you have entered all relevant information, please click the 'next' button to continue. If you have any questions, please feel free to email us at sales@achost.ca before you order.
 
PLEASE NOTE THAT ALL PRICES LISTED ON THIS PAGE ARE IN CANADIAN DOLLARS. $1.00 UNITED STATES DOLLAR = $0 CANADIAN DOLLARS
 
All fields marked with a * are required.
Hosting Plan Information

Hosting Plan: Basic Website Hosting
Details: 50mb space, 5gb transfer, more...
Price: ($1 CAD = $0 USD approx.)
Promotional Code:
 
Customer Information

First Name: *
Last Name: *
   
Phone: *
Email: *
Address: *
City: *
Province/State:
Country: *
Postal/Zip Code:
 
Domain Information

Domain Name: Currently Registered? Yes No
If the domain is not currently registered, please note there will be a surcharge if paying monthly
   
Password

Password: * (minimum 6 characters)
Confirm: * (minimum 6 characters)
 
Payment Method

PayPal Cheque/Money Order
 
Policies

I have read and Agreed to the Terms of Service and Acceptable Use Policy.
  Yes No