Baptist Web Site
Hosting Registration Form
Instructions for payment by check:
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(1) Please fill out this form. Be sure the Domain Name is available. (2) Print it by right clicking on the form. Click PRINT
(3) Enclose a check for $60.00 - $80.00 if also
paying for a standard Doman Name. Please make the appropriate adjustment for: .asia .me .name .tv .cc .eu .tel .ws .mobi Please make check payable to "Dan Souza"
(4) Mail form and payment to: |
| Full Domain Name www. | |
| First Name | |
| Last Name | |
| Organization | |
| Street Address | |
| Address (cont.) | |
| City | |
| State/Province | |
| Zip/Postal Code | |
| Country | |
| Phone Contact | |
DISCLAIMER: Accounts will be established on a good faith bases when check is received. If check will not clear, then the account will be suspended until funds are secured. Invoices are due upon receipt.