Virtual Server Level 1

Virtual Server Level 1

Link from PrairieWeb Business Pages

2 MB of storage – 250MB of transfer

Full Domain

MS FrontPage extensions and Web Publishing Wizard

Information:

Company Name:

Contact:

Street Address:

City:

State:

Zip Code:

Phone:

Business Purpose:

Email Address (if any)



Domain Name:

First Request for Domain:

Second Request:

User Information:

This information is to allow you access to your Virtual Site. Your username can be no longer that 16 characters and cannot contain a special characters. Please choose two(2) usernames in the event that the first is taken.

Username:

Username #2:

Password

Terms of Agreement:

Do you Agree to abide by the terms and conditions (click here to view)?   I Agree

Account Information:

All virtual accounts are billed one year at a time.

Billing Information: check here if same as above.

Company Name:

Contact:

Address:

City:

State:

Zip Code:

Phone:

Payment Type: Credit Card (Visa, MasterCard)
Send an Invoice *

Credit Card Information:

Name on Card:

Card Number:

Expiration Date:

Amount: $299.40 + $50 setup fee.

*invoiced accounts will not be activated until payment is received.

Comments:

Company Name:
Contact:
Street Address:

City:
State:
Zip Code:
Phone:
Business Purpose:
Email Address (if any)

Domain Name:

First Request for Domain:
Second Request:

User Information:
This information is to allow you access to your Virtual Site. Your username can be no longer that 16 characters and cannot contain a special characters. Please choose two(2) usernames in the event that the first is taken.
Username:
Username #2:
Password

Terms of Agreement:
Do you Agree to abide by the terms and conditions (click here to view)? I Agree

Account Information:
All virtual accounts are billed one year at a time.

Billing Information:	check here if same as above.
Company Name:
Contact:
Address:

City:
State:
Zip Code:
Phone:

Payment Type:	Credit Card (Visa, MasterCard) Send an Invoice *

Credit Card Information:

Name on Card:
Card Number:
Expiration Date:
Amount:	$299.40 + $50 setup fee.
	*invoiced accounts will not be activated until payment is received.
Comments:

Virtual Server Level 1

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