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Web Hosting Order Form

First Name:Middle Initial:Last Name:(e.g.,John F. Jones)

If this is a personal account, please enter your first and last name.

Street Address:

City:State/Province:Zip/Postal Code:


Phone Numbers:

Home Number:Work Number:

Email Address:

How did you hear about us?

I do not have a domain, I want you to register it for me.

I have a domain, please help to transfer it.

Domain Name:

(allowed characters are Digits, Letters and "-")

Password *(this will be your account password)

Additional Services

Do you need Front Page extensions?
FrontPage 2000 extensions will only work once your domain is active!


Web Design (HTML Coding)
Do you need our professional designers to create your web site?
Call for price.


Banner design
We design a winning banner for you which you can use for advertising and promotion of your website
Call for price.

$24.95 / Month paid annually at $299.40 plus $25 initial setup fee. Total = $324.40