Secure Order Form


	*Secure Online Order Form:*


	Please complete the following secure order form to begin the setup of your web account. Orders of virtual hosting services are set up the same day.


	Personal Information

Email Address	Please verify that your E-Mail Address is completed correctly,this information is vital in processing your order. Also note, we rarely accept e-mail address's from freemail services. We would prefer that you use the e-mail account with your ISP. Also, please use an email address different from the domain name you are signing up with.
Your Name
Company
Address
City
State	(2 letter if in US)
Zip code
Country
Phone
Fax

ESL's Domain Account Packages	Set Up	Monthly
Mega Account [http://www.YourName.com]	FREE	$ 49.95
Mini Account [http://www.YourName.com]	FREE	$ 39.95
UltraMini Account [http://www.YourName.com]	FREE	$ 32.95
SPECIAL1 Account [http://www.YourName.com]	FREE	$ 28.95
NT 1 Account [http://www.yourdomain.com]	FREE	$ 49.95
NT 2 Account [http://www.yourdomain.com]	FREE	$ 37.95
Select One

Domain Name Information
Domain: www.domain.com or http://domain.com only domain.com or ESLLLc.com. Please do not include WWW or HTTP://	Http://www. You can purchase a new domain name from ESLLLC.com for $24.95 a year or ( any other registrar.) There is NO additional fee for: ESLLLC.com Please verify that your domain name is available here (opens in new window)
Transfer using Internic	the above domain with INTERNIC or NETWORK SOLUTIONS ONLY. And you are transferring the above domain name from another host to ESLLLC.com.

Password Choice

Choose the password of your domain name account. You will use this password to log in to our servers and transfer your web pages. Your password must be 6 or more characters in length, can consist of letters (a-z) and numbers (0-9), and is case sensitive.

Password

Verify Password


	Price Chart

Plan	1 Month	3 Months	6 Months	12 Months
Mega	$ 49.95	$ 149.85	$ 249.75	$ 499.50
Mini	$ 39.95	$ 119.85	$ 199.75	$ 399.50
Ultra Mini	$ 32.95	$ 98.85	$ 164.75	$ 329.50
Special 1	$ 28.95	$ 86.85	$ 144.75	$ 289.50
NT 1	$ 49.95	$ 149.85	$ 249.75	$ 499.50
NT 2	$ 37.95	$ 113.85	$ 189.75	$ 379.50


	Payment Type / Term

Payment Type
Payment Term


	Credit Card Information

Name on Card
Card # (no spaces or dashes "-")
Exp Date	Month Year
Card Type

NOTE: JCHosting may call the owner of the credit card to confirm
charges to the card.


	Please read our policies(Opens in new window) Please press submit only once, and be patient.

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	ESLLLC email: eslinc@aol.com Copyright© 2001-2003 All Rights Reserved.