Web Hosting Secure Order Form

WEB HOSTING SECURE ORDER FORM

	BIZ-START BUSINESS WEB HOSTING PLAN
	BIZ-START Web Hosting Package incl. Activation Fee, 100 MB Server Space,1GB Traffic, Free Domain Name .com .net .org .biz .info, Free Business Submission to 1500 Search Engines, High Performance Apache Web Server , FrontPage 2000 Extensions, Unlimited Updates, Email Auto Responder, 5 Email Boxes, 10 Email Aliases and more...

Payment Options :

	BIZ-BRONZE WEB HOSTING PLAN
	BizBronze Web Hosting Package incl. Activation Fee,150 MB Server Space,2GB Traffic, Free Domain Name .com .net .org .info .biz ,Free Business Submission to 13000 Search Engines, High Performance Apache Web Server or NT 2000, Active Server Pages Support (only NT 2000),FrontPage 2000 Extensions, Unlimited Updates, Email Auto Responder, 12 Email Boxes, 20 Email Aliases and more....

Payment Options :

BIZ-SILVER WEB HOSTING PLAN

BizSilver Web Hosting Package incl. Activation Fee, 200 MB Server Space, Data Transfer
unlimited , Free Domain Name ..com .net .org .biz .info, Free Enterprise Submission to
800.000 Search Engines, High Performance Apache Web Server or NT 2000, Active
Server Pages Support (only NT 2000),FrontPage 2000 Extensions, Unlimited Updates,
Email Auto Responder, 20 Email Boxes, 20 Email Aliases and more....

Payment Options :

	BIZ-GOLD WEB HOSTING PLAN
	BizGold Web Hosting Package incl.Free Miva Shopping Cart System, Free Domain Name .com .net. org .biz .info, 300 MB Server Space, Data Transfer unlimited, incl. Free Enterprise Submission to 800.000 Search Engines, High Performance Apache Web Server or NT 2000, Email Auto Responder, Unlimited Updates, Active Server Pages Support, FrontPage 2000 Extensions, 25 Email Boxes, 40 Email Aliases and much more! All that your business need to be successful...
	Payment Plan -Setup Fee: 1Mo/$149 \| 3Mo/$129 \| 6Mo/$100 \|12Mo/Free Setup \|

Payment Options :

ADDITIONAL SERVICES

Database / MS SQL/Access Database $ 19/Month :
Additional Mailbox $ 15 yearly :
Real Server for Media Streaming $39/month/100 MB :
Web Trends Server Server Log Statistic Year $22 :
Custom SSL SECURE SERVER Certificate $ 125 :

Your Existing Domain Name :	.
Your NEW FREE Domain Name :	.

INFORMATION about your Company


* required Fields	We need all information for your registration !
*Company:
* Your First and Last Name:
Title:
* Address:
* City:	*State:
* Country:	*Zip:
* E-mail address:
* Phone:
Fax:
Mobil Phone:
Toll Free:

INFORMATION about Billing


We accept:

* required Fields

* Credit Card:

* Credit Card Holder:

* Credit Card Number:

* Expiration MM/YY:

Credit Card Security ID:

Illegible

	In an effort to reduce fraud we asking for the Security ID for the cards listed below. If your card does not have a Security ID on it you may leave the field blank. If the Security ID on your card is unreadable, you should check the "Illegible" box. See the links below for an image of the location of the Security ID on your card.

	American Express : Security ID is printed on front of card above the credit card number.
	Euro Card : Security ID if available is printed on back of card after the credit card number.
	Master Card : Security ID if available is printed on back of card after the credit card number.
	Optima : Security ID printed on front of card above the credit card number.
	Visa : Security ID is printed on back of card after the credit card number.

Credit Card Billing Address

* Postal /Street Address:

* City:

*State:

* Country:

*Zip:

Additional Info's:

INFORMATION about our Service


Registration fees and setup fees are non-refundable. Thanks for your order , we will setup your Web Server ASAP ! Your Web Hosting Team
	I agree to the Hosting Terms


	Any Question please call 1- 888-398-4703 or international +1-760-736-3700

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