Web Site Hosting by Internet-BC
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Internet-BC Order Form

I've read the terms of service and agree to all of them, and I wish to apply for a new hosting account.

We must be able to reach you at the email address that you provide, or no action will be taken. Most fields are required. If you have missed a required field, you will be reminded when you click on the submit button. Domain name registration and your initial hosting invoice must be paid by credit card (Visa or MasterCard) upon receipt of the invoice.

Use the tab key to move between fields, or click on the next field with your mouse.

Company Name
Your Name - must be an individual
Your email address Check for accuracy. Please
to let  us know if you change your email address.

Preferably not a free email account like Hotmail, Yahoo, etc.
We must be able to reach you by this email address.
Telephone (e.g. 555-555-5555)
Fax Number
Address 1
Address 2
Province or State
Postal Code (include space in Cdn Postal Code)


If you will be uploading your site yourself, just leave this section blank. If someone else will be your web designer, enter their name and email address here. 
Your webmaster's email address


Domain Name to be hosted (don't enter "www")
Second Domain name (pointer)   (if any)
A second domain name can be pointed at the hosted domain for a one time charge of $10
This is a
If you qualify, you can click here to register your .CA Canadian domain name.
You still have to complete this hosting application form to activate your web site.
Domain Name Registration
  • We can register .CA. .COM, .NET, .ORG, .INFO, (etc.) domain name for you. This field is only required if we are registering a domain name for you. Save money with multi-year domain name registration.
For .CA Domain Names Only...

To verify that you are qualified to register a .CA domain name, visit CIRA

Further, if you chose a .CA domain name and selected Corporation, Unincorporated Association or Partnership, this must be filled out.

Hosting package
FrontPage - Do you wish to have the FrontPage Server Extensions enabled:   YES     NO 
  Do not select "yes' unless you or your web developer has MS FrontPage.
If you select "no" you will receive FTP instructions for uploading your files.
New email account
e.g. for info@yourdomain.com enter just info
Request one email account for now. Additional accounts can be added later.
What Email Client do you use? e.g. Outlook, Outlook Express, Eudora, etc.


Describe your business.
What will you use your web site for?
You will receive your invoice shortly.
Hosting & Domain name registration fees are payable by credit card upon receipt.
I have read the "policy & terms of service" and