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Hosting Order Form
Please enter the information below to create a new hosting account.

Domain Information
Domain Name: http://www. 


I own this domain name, and I would like to keep it registered with its current registrar.
(You will continue to pay a registration fee and manage your domain through another registrar)
I own this domain, and would like to transfer it to Webmasters.com for registration.
(This will add 1 or more years to your current registration, and future renewals will be free with hosting)
I want to register this domain name right now free with hosting.
(A registered domain name is required to set up a hosting account)
I own this domain name, and it is already registered with or is being transferred to Webmasters.com.
(You will receive a discount on hosting equal to your annual domain registration fee of $9.95)
Contact Information
Organization Name:
Contact Name:
Street Address:
City/State/Zip:
  
Country:
Telephone Number:
Fax Number:
Email Address:
If possible, please do not list an email address at the domain being set up.
New Account Information
User Name :
(5 to 8 characters)
Password :
(6 to 15 characters)
* You will need the above user name and password to administer your site.
Confirm Password:
Hosting Features
Optional features can be added or removed at any time at a prorated fee.
Business Hosting:  $9.95/month
Secured.com SSL:
$5.00
Unique IP Address:
$5.00
BackupMail:
$5.00
Monthly Cost: $
Annual Cost: $
*** For higher security, we do not provide Telnet/SSH access.
Additional Comments
Please enter any special instructions or comments below (optional):
 

How did you hear about us?

If you were assisted by our sales staff, please include the representative's name above if known.
Payment Information
My billing name and address are the same as my contact information.
Billing Name:
Billing Address:
City:
State/Province:
Zip/Postal Code:
Country:
Payment Type:
Credit Card
Check (U.S. Only)
    
NOTE :
If you cancel within the first 30 days for any reason, you will receive a 100% refund.
1. Please read the Service Usage Policy by clicking here.
2. Please read the Internet Service Agreement by clicking here.
I have read, understood, and agree to the terms in items 1 and 2 above.
I request the sum of $   USD to be charged to the above account.
Save my profile for future orders (credit card data will not be saved).
  
Process
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