IB Design Studios - Hosting Package Order Form

Fields marked with an asterisk (*) are required.

*First Name:

MI:

*Last Name:

Business Name:

*Address:

*City:

*State:

*Zip Code:

*Phone Number:

1- - (Area Code Required)

Alternate Phone:

1- -

Choose a hosting package from list below.

*Hosting Package:

*Domain Name:

*Do You Already Own The Domain Name?:

Yes No

If No, Would You Like
Us To Register It?:

Yes ($21.95/year) No

If Yes, Would You Like
Us To Add Privacy Protection?:

Yes ($6.95/year) No

Enter the email address where you want your billing statements and receipts sent.

*Billing Email:

Do you want to pay with check or credit card?:

Check Credit Card - We will contact you for details by phone.

*I have read and agree to IB Design Studios Terms and Conditions and authorize
IB Design Studios to charge my credit card for the services ordered above.