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Web Design & Development:  Account Setup

 

Congratulations.  You're on your way to a professionally-developed website.  The information below will assist us in setting up your Web Design Account.

Web Design Account Setup Form

If you're not sure about something, please email us or call 478-922-5510.

Domain Name & Hosting Information:
I have already registered my domain name.
     It is www...

I have not yet registered a domain name.

I have a web hosting provider.
     My web hosting provider is .

I do not currently have a web hosting provider.  Please set up a web hosting account for me.

NOTE:  Unless otherwise specified in the Comments section below, a 25MB hosting account ($29.95/month) will be set up using the information from this form.
Billing Information:

Contact Name:

Company/Organization:
Address:
City:
State
Zip
Phone:
Fax:
Email:
Administrative Contact (if different from Billing Information):

Contact Name:

Company/Organization:
Address:
City:
State
Zip
Phone:
Fax:
Email:

Comments:

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