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Site Express Order Form

 

Domain Information

Enter Your Domain Name Here:* www.
(Don't forget .com, .net etc.)


Choose a NEW DOMAIN if you are registering the domain

for the first time AND would like to register the domain name

through Computer Solutions 911 Hosting.


New domain

Please select the number of years for which you

would like your domain registered:

New domain registration costs $16 a year.


Choose, the option below if you have already registered your

domain name with someone else and would like Computer

Solutions 911 Hosting to simply host your web site, or e-commerce web site.


I will handle my Domain Registration/Transfer.

 

Hosting Information

User Name:*
The user name must start with alpha characters in lower case, but can consist of numeric characters. Up to 8 characters.

Account Package:*

Contract Length:*

How did you find CS911 Hosting?*

 

 

 

Client Information

 

This information must match the address on your credit card statements or your order will be declined.

Name (first, last):*

Company Name or Domain Name: *

Address:*

City, State, Zip:*

Country:


State (if other than the U. S. or Canada):

Phone Number:*

Fax: (optional)

E-Mail:*

Please enter an e-mail address below that does not use the domain name you are submitting. If you only have one email address, then please use that address here too.

Alternate E-Mail:
(Off-Network Email Address):*

 

 

 

Contact Information

Use the information above for the Administrative Contact information.

Use the information above for the Billing Contact information.

Have us be your Technical Contact.

 

Complete my order now!