Setup Form - New Accounts
Hosting and/or Web Design Request
Select Hosting Plan Desired
Standard $35.00 (per month)
Advanced $45.00 (per month)
Supreme $60.00 (per month)
Custom web site:
New domain name
Domain name you would like to have:
If you have a domain name, will it need to be transfered?
Select
Yes
No
Domain name to be transferred:
Information About You
Name:
Address:
City:
ST:
Zip:
Phone:
The best time be reached:
Select
AM
PM
Most convenient day to call:
Select
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Email Address:
Questions or Comments:
Your submission of this form acknowledges that you have read and agreed to accept our
Terms of Service
.
Open New Account
Web Design/Hosting
Email:
eb@netprojections.com
Phone/Fax
785-228-3505
785-845-5785 (cell)
Complete & Mail
Hosting Contract
Web Design Contract