WEB
HOSTING
ORDER FORM |
COMPLETE FORM TO ACTIVATE YOUR ACCOUNT |
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| Domain Registration: |
Register New Domain
Transfer Existing Domain |
| Domain Name: |
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| Plan Type: |
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| Plan Length: |
$49 Setup Fee Waived
for 12 & 24 Month Plans! |
Pick a user name
(4-8 characters): |
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Pick a password
(4-8 characters): |
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| Special Instructions: |
Note: Additional
products such as disk space and mail options
must be requested via phone or e-mail. |
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Check here if
you want Microsoft FrontPage
extensions installed for this account. |
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Check
here to have us send your domain
registration or modification template to InterNIC on your behalf. |
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| First Name: |
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| Last Name: |
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| Company Name: |
(For domain transfers,
make sure you use the same company
name that is on record with the InterNIC.) |
| Address: |
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| City: |
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| State/Province: |
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| Zip/Postal Code: |
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| Country: |
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| Phone: |
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| Fax: |
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| E-mail Address: |
(a contract will be
emailed to this address) |
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Are you an CTE
Computer.com Internet
access customer? |
yes no |
How did you find
out about us? |
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| Payment Information |
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| Payment Type |
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| Credit Card Number |
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| Credit Card Expiration |
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| Name on Credit Card |
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| Card Holders Address |
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| Card Holders City, State, Zip |
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| Card Holders Phone Number |
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| Additional Instructions |
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| I agree to all Terms and
Conditions and hereby authorize all expenses associated with this account. |
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By submitting this form I
hereby declare that I own or have permission to use the above credit card.
NOTE: Monthly payment option is only available for Credit Card accounts.
Accounts paid by Cash or Check must be prepaid annually and sent to our US
Mail address. |
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| Back
to Plan Descriptions |
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