Web Hosting Order Form
Thank you for choosing to host your website with Off The Wall Web Works!

Ordering web space is a simple two-step process.

1. Fill out the following form with your preferred hosting package, domain name and contact information.

2. Enter your payment information. At the present time Off The Wall Web Works accepts , and checks (or money order).

To setup your new account, we need the following information:

Hosting Package: Personal - 20 MB package - $10.00/mo. Economy - 50 MB package - $15.00/mo. Value - 100 MB package - $20.00/mo. Standard - 200 MB package - $25.00/mo. Power - 350 MB package - $30.00/mo. Ecommerce - 500 MB package - $35.00/mo. *

Site Domain name: *
(ex. yourcompany.com)

First Name: *

Last Name:  *

Company: 

Address: *
               

City:*

State:*

Zip:*

Contact information: Please list the phone number and email address that you would like us to use to contact you.

Phone number: *

E-mail address: *
 (Please use one outside of your requested domain)

How did you hear about Off The Wall Web Works?:

f you were referred by an existing
Off The Wall Web Works client, 
please put their domain name in the box below so we can thank them.

Do you want FrontPage extensions installed?: Install FP extensions

Do you need help registering your domain name?

No thank you.  I will enter the nameserver values with my registrar.  (These values are sent in our welcome email)

Yes.  Please register this domain for me.  I understand that Off The Wall Web Works charges a $15 service fee, plus the registrar fee.

If you have a promotion code, please enter it here:

Please describe the purpose / intended content of this site:
(We use this information to spread the load of accounts likely to use extensive resources over multiple servers and to accommodate special server software needs)

Any additional comments or special setup instructions:

Submission of this order indicates agreement to our Terms and Conditions

* Required fields

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