Web Hosting Order Form
Company Information
* required field
Name*:
E-mail Address*:
Company*:
Address:
Address2:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KY
KS
LA
MA
ME
MD
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Intl
Zip:
Phone*:
Vhost Information
Domain Name*:
If an alias, of what domain:
Note:
If an alias, no need to fill out any further information...
Admin Password:
FTP Password:
Note:
If you do not include a password, we will generate one for you...
Plan Required
:
Mini ($10)
Standard ($30)
Full ($50)
Additional Storage:
None
100Mb ($2.50)
200Mb ($5)
300Mb ($7.50)
400Mb ($10)
500Mb ($12.50)
600Mb ($15)
700Mb ($17.50)
800Mb ($20)
900Mb ($22.50)
1Gb ($25)
ColdFusion
:
yes
no
ASP:
yes
no
PHP
:
yes
no
Anonymous FTP
:
yes
no
Streaming Media
:
yes
no
Secure Server
:
yes
no
Net Merchant
:
yes
no
SQL
:
yes
no
Web-to-Fax:
yes
no
Usage Report
:
None
Webalizer
Analog
E-Mail Information
If you need more mailboxes than come standard with your plan,
please order the extras here...
Additional Mailboxes
:
0
5
10
15
20
25
30
35
40
45
50
ListServ Lists
:
0
1
2
3
4
5
Premium spam removal service
:
yes
no
Check if you have your own MX:
Press "Continue" for payment total.
* required field
If you have any problems
,
please contact
support
or call 615 370-1530
Live Support