Billing Information
*
All Fields Required
Account Information
Email Address:
*
Domain to be hosted
.
*
.
ie.(domain.com)
First Name:
*
Hosting Package
$9.95 per mo. Basic Hosting
$24.95 per mo. Dynamic Hosting
Last Name:
*
Desired username:
*
Company:
Desired Password:
*
at least 6 characters
Street Address:
*
Email Accounts
Please list usernames for Your email Accounts
9.95 Plan 1 account
City:
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24.95 Plan 10 accts
State/Province:
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Zip:
*
Country:
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Contact Phone:
*
Terms/Conditions
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I accept the terms and conditions
Privacy Statement
R
evised 05/24/2006
All Rights Reserved by
JBC Dynamics
