Phone: 816-370-2546
Fax: 816-370-2217

Instructions

1. Print form from web page
2. Select desired options
3. Mail or Fax information
4. Include Credit Card Number if
   Faxed or Payment if sent via Mail
5. Activation of your website begins
   upon receipt of payment

Internet Hosting Proposal

For Domain Transfers:
Current Domain Registrar User ID: ______________ Password: ______________

Print Name: __________________________________

Signature: ____________________________________ Date: ______  /  ______  /  ______

Credit Card # ________  ________  ________  ________

Security Code (found on back) ________ Expiration Date: ________  /  ________

Pay by Check: ________ Check # ________

Hosting Plans / Form Effective on 02-09-05