First Name*
(* denotes a required field) |
|
| Last Name* |
|
Company Name*
Use your full name if this is
not for a business. |
|
| Street / Suite* |
|
| City* |
|
| State* |
|
| Zip Code* |
|
| Country* |
|
| Phone Number* |
|
| Fax Number |
|
| E-mail Address* |
|
A short description of your
business or service.*
(max. 60 words)
|
|
Select Account Size and Set
up fees
|
|
Domain Name Status*
If you are registering a new
domain name you will be charged $70.00 to register your domain
name for two years. Your new domain will be registered with
internic and you will be billed directly from Network
Solutions. We charge no extra fees
for that. If you want a 3rd level domain name (something.gibsolutions.com)
there are no registration fees for that.
|
Register New Domain Name
Transfer Registered Domain for
hosting
Domain is already pointing to
our DNS
3rd Level Domain (something.gibsolutions.com)
|
Domain Name*
Please double check the spelling of your domain name. |
WWW.
|
Microsoft FrontPageTM
Extensions
Will you be using FrontPageTM on your account?
|
Yes
No |
| Notes: |
|
Method of Payment*
|
|
| Type of Credit Card |
|
Card Number
(Please double check) |
|
| Expiration date (MMYY) |
|
| Name on the card |
|
| Cardholder's Address |
|
| Cardholder's Zip Code |
|
Automatic Credit Card Billing
Selecting "Yes" we will
automatically deduct all hosting fees from your credit card
each month. Contact our sales department for optional billing
methods.
sales@gibsolutions.com |
Yes
No |
| Referral
If a current Global Internet Solutions customer referred
you to us please specify their information.
|
Referral's Name:
Referral's Domain Name:
|
| Coupon Code
If you have a coupon code please enter it here.
|
|
Where did you hear about
us?
|
Banner Ad
Infoseek
Alta Vista
Yahoo
C|NET
Other Search Engine
Web Hosting Related Site
Word Of Mouth
Other
|
|
Please type your full name in
the box below. By doing so and submitting this form to Global
Internet Business Solutions Inc you are agreeing to the
terms,
conditions and acceptable use policy previously set
forth by Global Internet Business Solutions Inc.*
Before submitting your order please double-check it
for accuracy. Make sure you are registering the correct
domain name you want. The domain name registration fee
($70 / 2 Years) is non-refundable. Please also make
sure you filled out all the required fields.
|
