Web Hosting Account Form

	Web Hosting Services
	Basic Web Hosting
	Plus E-Commerce
	Gold E-Commerce
	Hosting Order Form

	Acceptable Use Policy
	Terms & Conditions

	Domain Name Registration
	Select a Domain Name
	Registration Agreement

	Web Design Services
	Web Site Maintenance
	Multi-Media Services

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	Technical Support

Web Hosting Account Order Form

The information you provide will be kept strictly confidential.

Your order will be processed as soon as payment is received. Most accounts can be activated within one business day.

Customer Information
First Name
Last Name
Email Address
Company
Title (optional)
Address
Suite or PO Box
City
State
Zip Code
Phone #
Please include the telephone number area code. Thank you.

Please select service need: Register new domain name, Transfer your current domain name to Digital Image Delights, or Manage your domain name yourself.
I Need A New Domain Name.
Domain Name
Select the number of years you desire your Domain Name.
Renewal Cycle
Transfer My Domain Name to Digital Image Delights If transferring current domain name, please enter the following information.
Domain Name
ISP/Host/Reg.
Host Phone #
Select the number of years you desire your Domain Name.
Renewal Cycle
I Will Manage My Domain Name Registration Myself

Please select desired web hosting package.

	Hosting Account Packages
Billing Preference	Automatically bill my credit card. (No setup fee and free domain name.) Email me an invoice. ($25 Setup fee & Domain Name fees will apply.)
Payment Method for this Order	Credit Card. Business Check. (Account will be setup after check clears.)
Billing Cycle	Basic	Plus	Gold
Disk space/Bandwidth	50mB/1gB	100mB/3gB	200mB/5gB
Monthly Rate	$ 16.95	$ 21.95	$ 41.95
Quarterly Rate	$ 45.95	$ 60.95	$115.95
Semi-Annually	$ 86.95	$111.95	$211.95
Annual Rate	$168.95	$213.95	$403.95