WEBMASTERS.COM Hosting Order Form (Check)

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Enter the information below to create a new hosting account. If you do not have a domain name already registered, please click here prior to completing this form.

Contact Information

Organization Name:

Contact Name:

Street Address:

City/State/Zip:

Country:

Telephone Number:

Fax Number:

Current Email Address:

If possible, please do not list an email address at the domain being set up.

New Account Information

Domain:

Password:
(6 to 15 characters)

Username:
(5 to 8 characters)

Confirm Password:

* You will need the above user name and password to administer your site.
Passwords are 5 to 15 characters. Valid characters are: aA-zZ, 0-9, ! # % ^ & *

Hosting Features

Optional features can be added or removed at any time with a prorated refund.

Business Hosting: $9.95/month

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?

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Payment Information
My billing name and address are the same as my contact information.
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Billing Address:
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State/Province:
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Country:

Check Type:

NOTE :
Even though we require annual payment, you can cancel at any time and receive a full refund for the remaining term (calculated instantly by our online cancellation form). 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.

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