Order Bronze

Bronze Plan Hosting - $15/month

Set-up is generally completed the same day, but may take up to 24 hours depending on circumstances. We will contact you after setup with your account information and domain nameserver change information. By submitting this order form, you warrant that you have read and agree to our Terms of Service.

Billing Information
Name as it appears on Card
Secondary Name on Card
Card Billing Address
City, State/Country, Zip	ST/Country Zip
Telephone Number	()
eMail for Billing Receipts
NOTE: We will telephone you to obtain your debit/credit card number and expiration date.

Domain Information (Complete One Box ONLY)
Complete the following ONLY if you already have a domain name (yourname.com) registered:
Existing Domain Name

Complete the following ONLY if you do NOT have a domain name registered and would like us to register your domain for you. Note: We will register the domain name for 2 years with Network Solutions and bill you $50.00 on the intial hosting billing.
New Domain Name


I agree by submitting this order to allow CompanyName to charge my debit or credit card an initial payment for internet services which includes (a) the prorated amount for the first month of service, (b) a one-time setup fee of $10 (applicable only if this is a new domain), and (c) domain registration fees (if applicable). I also agree to allow CompanyName to charge my debit or credit card monthly on the first day of each month for the month of service. This agreement will be in effect until cancellation by either party in writing at least 7 days before the first of the month. Submit this form ONCE ONLY

Bronze Plan Hosting - $15/month

Submit this form ONCE ONLY