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Web Site Hosting
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Web Hosting
Order Form

WebStar Media WEB Hosting ORDER FORM

Use this form to order any of our Web Hosting Services TODAY! If you need web page design, graphics design, or any other services then please use our "General Services Order Form".
Accounts Will Be Open within 72 hours of receiving your payment.
Please allow up to 7 days for New Domain Registration and Domain Tranfers.
* - InterNIC will bill you $100.00 separately for domain name registration.
This covers a period of two years with subsequent years costing $50.

All Items In BOLD are Required!

Hosting Choice:

New Domain Transfer existing Domain Non-Domain

Domain Name:
Check Name

Customer Information

Name:
Company Name:
Type of Business:
Address:
City:
State/Province:
Country:
Zip/Postal Code:
Daytime Phone:
Home Phone:
FAX:
Email:

Web Hosting Option
(Enter your hosting requirements along with the prices you have chosen from one of our web pages)

Payment Method
MasterCard
Visa
Check/Money Order
(WebStar Media will set up your account upon receipt of your payment)
Please remit Payment to:
Send this form with submit or Email to: WebStar Media or Postal Mail to:
WebStar Media Internet Services
P.O. Box 399
Lubec, ME. 04652

Card#:
Expires:
Cardholder Name:

Additional Comments:
Where Did You Hear About Us?:
Search Engines
Direct Email
Our Website
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Other

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Thank you for using Site-City

Web Site Hosting ORDER FORM

WebStar Media WEB Hosting ORDER FORM

Web Site Hosting
ORDER FORM