WEB HOSTING ORDER FORM

Use this form to order any of our Web Hosting Services TODAY! If you have problems with this form please email your request to: Hosting Order Dept. Accounts Will Be Open within 72 hours of receiving your payment.  Please allow 2- 7 days for New Domain Registration and Domain Tranfers.
* - InterNIC will bill you $70 separately for domain name registration. This covers a period of two years with subsequent years costing $35.

As soon as the account is set up our nameservers will be answering for that domain name. Getting the appropriate NIC to transfer authority to us is your job, but for hints and help if you have a .com, .net, or .org domain check out our pages on dealing with the InterNIC.

If you're not going to use a domain name with this account, come up with a short identifier for your site. Your URL will then be http://trafficblaster.com/~xxx/ for whatever xxx you like. Tell us what you like here (upto 10 characters):

Customer Information

Web Hosting Option (choose one)
Which account type do you want? Click on the item "link" to find out more price details, etc.
TB1     TB2  TB4  TB5  TB6

 TB100   TB1000   TB1500   TB500

I agree to the following amounts
(please click on the links above for details and prices):
One Time Setup Fee:.............................................
Hosting Fee Based on Invoicing checked below:....+
Other.................................................................+
Grand Total.........................................................=

Invoicing (choose one)
Monthly     Quarterly      Yearly

Payment Method (choose one)
  MasterCard        Visa        Check/Money Order

Bills will be sent by email if you pay by check.  If you will pay by credit card your card will be automatically billed.

(TrafficBlaster will set up your account upon receipt of your payment)
If paying by check (US Postal Mail) please remit Payment to:
Send this form with submit or Email to: order@trafficblaster.com
and Postal Mail to:
TrafficBlaster Internet Services
P.O. Box 399
Lubec, ME. 04652

Please describe here (in brief) the amount you are paying and what services you want. 
This is used to re-enforce the items you have checked on this form

 
Where Did You Hear About Us?:
Search Engines
Direct Email
Our Website
Print Advertising
Other

When we make the resellers option available, would you be interested in becoming a reseller? Yes    No

Thank you for using TrafficBlaster Hosting