By completing and submitting the form below you accept and agree to adhere to Snappy Design
ACCEPTABLE SERVER USE POLICY
CONTACT INFORMATION:
(All fields with an asterisk* are required)
All Prices are in Canadian Dollars
Canadian customers please add 7% GST where applicable.
*First Name:
*Last Name:
*E-Mail Address:
*Address:
Address 2:
*City:
*State/Province:
*ZIP Code/Postal Code:
*Country:
*Phone Number:
ACCOUNT INFORMATION
* Enter Desired Domain Name:
Examples:
"yourdomain.com"
* Enter Desired Username:
NOTE:
This must be 6 to 8 characters long. Usernames can not be changed once the account has been established.
* Status of this Domain Name:
New domain name, please register it for me
New domain name, I am handling the registration
Existing domain name, please trasfer it
I will do the transfer my self
NIC Handle:
NOTE:
If this is an existing domain name and you are requesting that we transfer it to our servers, please provide your NIC handle here.
Referral Code
* Choose Your Account Option:
Please Select One
100MB $39/month Canada Dollars
200MB $44/month Canada Dollars
300MB $49/month Canada Dollars
The default is our $39/month hosting account.
BILLING INFORMATION
* Credit Card Type:
Visa
American Express
Master Card
* Credit Card Number:
* Expiration Date:
* Name On Credit Card:
* Billing Address 1:
Billing Address 2:
* City:
* State/Province:
* ZIP Code/Postal Code:
* Country:
* Card Holders Phone #:
(Include Area Code)
Card Holders Email Address:
* How many months would you like to pay at a time:
1 Month at a time
3 Month at a time
6 Month at a time
NOTE:
The credit card that you use to activate your account will be automatically charged each month on the anniversary date of account activation, unless you have chosen to pay for multiple months.
Total Amount To Charge
To My Credit Card
NOTE:
This is the total amount you are authorizing us to charge to your credit card for this transaction. If this transaction includes a domain name registration, the registration fee will only be charged this one time. Only the monthly fee pertaining to the account plan you have chosen will be automatically billed on this day each month hereafter.
NOTE:
We can register your .com, .net, .org domain name for you, please add $35.00 to the above amount for one year of domain name registration fees.
Additional Comments:
Once you have completed this request and submit it, your initial account will be setup within 1 day. You will receive an email confirming setup.
Please review this form before submitting. For security purposes, your remote address and user agent are traced through submission.
By submitting this form you acknowledge, that you have read and understand the
ACCEPTABLE SERVER USE POLICY
and agree to be bound by the terms of this Agreement
© Copyright 1999 Snappy Design. All Rights Reserved.
