123ehost.com - Fast & Reliable Hosting

Pay By Postal Mail

If you would like to purchase a hosting plan by Check or Money Order via Postal Mail, please follow the instructions below for your convenience:

Please send Personal or Company Check or Money Order payable to:
Imagine Multimedia
Mail to:
Attn: Accounts Receivable
Imagine Multimedia
400 Cure-Labelle Blvd., suite 501,
Laval, Quebec H7V 2S7
Canada
Notify 123ehost.com that you have mailed it by filling out this form and pressing the submit button:
Please add your domain name in front of your check.




		We use Secure Socket Layer (SSL) technology to send your payment information to our servers.
Account Information
Payment Period:		Basic - $50/Annually + $25 one time setup fee.
		Premiere - $23.85/Quarterly + $25 one time setup fee.
		Premiere - $75.00/Annually -no setup fee.
		Ultra - $99.00/Annually - no setup fee.
Password:	(6 - 12 characters)
Confirm Password:
Domain Name:


Contact Information - We will use this information to contact you to send you, your welcome email.
First Name:
Last Name:
Email Address:
Phone Number:
Company Name:
Address:

City:
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Country:
Zip / Postal Code:
How did you hear about us?:

I understand and agree to the terms of the 123ehost User Agreement .