Name:
Company:
Address:
City:
State:		ZIP:
Country:
E-mail Address:
Confirm E-mail:
Phone:		Ext.
Contact Time:		AM   PM   After Hours
Web Hosting Plans:
Order	Plan	Setup	Monthly
	Budget	$20	$10
	Small Bus	$20	$20
	Standard	$30	$30
	Deluxe	$45	$45
	Developer Level 1	$75	$60
	Developer Level 2	$75	$80
	Developer Level 3	$75	$100
Webmail Only:
Order	Plan	Setup	Monthly
	Webmail	$20	$10
Domain Registration:   $15/year
Order	Name to Register
Contact Information for Domain
Name:
Company:
Address:
City:
State:		ZIP:
Country:
E-mail Address:
Confirm E-mail:
Phone:		Ext.
â la Carte:
Order	Item	Setup	Monthly
	Add'l. Domain	$30	$5
	Domain Alias	$15	$2
	FTP Access	$10	$0
	Secure Web Space	$20	$2.50
	WebTrends Reports	$20	$2.50
	ODBC DSN	$10	$0
	Add'l. SQL Database	$25	$15
	Add'l. 25MB SQL	$0	$15
	Dedicated IP	$10	$5
Special Instructions: