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Personal Hosting Plan Order Form

Use this form to pay 6 or 12 months in advance.
We will remind you when addition payment is due.

 Pre-pay for Personal Hosting $4.95/Mo.
(How many months to pay in advance)
New Domain Domain registration $15.00/Yr. (TOS agreement required)
(Check the box if you need us to register your new domain)

Domain Name


(The name you have or want to register)

Login Name

 
(lower case name, used to login and as your default email account)

Password


(Enter a password longer than 4 characters, 6-10 recommended)
Credit Card  
First Name
Last Name
Address
City
State
Zip
Country
Phone
e-mail

  

Click to enter your credit card number
You will receive confirmation of your order by email.

Note:  If you prefer to pay by check or money order, mail it to the address on the left.

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