s.js?v=1500596387.0" charset="utf-8"> Web Hosting Order Form

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Web Hosting Order Form

Web Hosting Order Form


Please Enter the Domain Name here: www.
New Domain?
DON'T DO ANYTHING (I will handle my Domain Name registration or transfer).
User Name
Account Package - Economy - Basic - Deluxe - Commerce - Professional
Invoice Type? E-Mail or Paypal?
Billing Cycle? One month - Three months - Six months - One year
Name (First, Last):
Company:
City, State, Zip:
Phone
Fax:
E-mail address:
Please enter an additional e-mail address below. This address should not include your new domain name, providing us with an alternative way to contact you via e-mail.
E-mail address:

Comments?






Any illegal activity, including adult content, links to adult content web sites, spamming or hacking will result in us shutting you down and deleting all files.

Please read the restrictions before submitting.
By submitting, you are agreeing to an implied contract of service with Parrotscentral Web Hosting and Design.

To pay by credit card use Paypal.
Payee at Paypal: birdeega@mindspring.com

Make payments with PayPal - it's fast, free and secure!






To pay by check:
Make check payable to Judy Thacker.

Mail check to:

Judy Thacker
309 Iron Horse Way
Stockbridge, GA 30281

Your account will be set up within 24 hours of receiving check.
$28.00 charge for any returned check.

Any account 10 days past due will be charged a 15% late fee.
Any account 30 days late will be removed.