Web Site Services Order Form

1. Personal Information
First name
Last Name
Company Name
Type of Industry
Address
City
State
Zip
Phone
Fax
Email


2. Domain Name
Enter Your Domain Name(Including .com, .net, .org, etc.):

New Registration* Transfer* Already Registered


3. Packages

Select Your Hosting Package:

Select Your Maintenance Package:

Please indicate the status of your web site:

"I would like an estimate to design a new site!"
" I would like an estimate to redesign my existing site!"
" I am happy with my existing site!"

Special features or considerations for your new site that we should consider in our estimate:


4. Terms

*Please Note: If you are registering a new domain with your web hosting order, you will be billed a new domain registration fee of $35.00/year and this charge is automatically renewed each year. Transfers from another domain registrar $15.00 and extend your expiration date another year. Your email address on this application must match the email address on the national registry. You will be notified if it does not.

All our billing is done by mail or email. Payment is expected within 30 days. Annual contracts are billed on a monthly basis or you can opt to be billed on a quarterly basis.
 
IMPORTANT: By placing your order, you are stating that you agree to follow both our Terms Of Use and Billing Policies. If you don't have a copy of these, please email us your request.

 

Powered by STB Solutions of Fayetteville, Inc. | Copyright © 2004 | All Rights Reserved | Site Map | Contact | Help Center