BestWebHost.com Secure Sign Up Form

Domain Name:
Use this form to sign up for web hosting
if you already have a domain name with ANY extension including
.com , .net , .org , .us , .name , .biz , .info or any other choice
Use this form to sign up for web hosting and a NEW domain name
with the extensions .com , .net , .org , .biz , .info , .name

Click here to sign up for a NEW Domain Name with the extension .us

First and Last Name:
Company Name
Is This Domain Name Already Registered In Your Name?	Please Type Yes or No in this field
Street address:
City and State:
Zip/Postal Code:
Phone number:
Country:
E-mail address:
Log-in Name	Your choice of eight lower case letters and or numbers You must start with a letter not a number
Password	Your choice of eight upper and lower case letters and or numbers
ReType Password	Your choice of eight upper and lower case letters and or numbers
FrontPageExtensions	Do you want Front Page Extensions enabled on your site? We can add them in the future at no charge- if you are not sure choose NO Please Type Yes or No in this field

Choose a Web Hosting Plan	12 MB = $9.99 a month ( transfer my domain name to your web hosting- no additional fee ) 12 MB = $9.99 a month and register a new domain name for an additional $14.99 a year 50 MB = $14.99 a month ( transfer my domain name to your web hosting- no additional fee ) 50 MB = $14.99 a month and register a new domain name for an additional $14.99 a year 100 MB = $24.99 a month ( transfer my domain name to your web hosting- no additional fee ) 100 MB = $24.99 a month and register a new domain name for an additional $14.99 a year 200 MB = $29.99 a month ( transfer my domain name to your web hosting- no additional fee ) 200 MB = $29.99 a month and register a new domain name for an additional $14.99 a year Domain Name Registration or Transfer for $14.99 a year--no web hosting included Please Paste or Type In One of The above choices
Payment Information	We Accept Visa, Mastercard, American Express Credit and Debit Cards, Checks and Money Orders We only accept payment in US currency To Pay by Check or Money Order Please fill out this form and click submit below and please make check to: Best Web Host, Inc. , PO Box 10224, Phoenix, AZ 85064-0224 For Credit card or Debit Card payment, Please fill out this form and click submit below and then please call Arizona Telephone Number: 602-265-8247 or Outside of Arizona Call TOLL FREE: 1-877-THE-HOST (1-877-843-4678) On your credit card or debit card statement, the credit card charge will be from Best Web Host , Inc.
	We accept VISA and MASTERCARD and American Express Credit and Debit Cards in US funds
Recurring Monthly Billing	Please be sure to read all of the following Terms Of Service Agreements. Click Here To Read Best Web Host , Inc. Terms Of Service Agreement Click Here To Read ICANN's Registration agreement for Domain Names Click Here To Read DOC Registration agreement for .US Domain Names Click Here To Read Registrar agreement for .name Domain Names

Comments:

If this is a new domain name, after you sign up, sit back and relax--
we will let you know when your name is official.
Your credit card will be billed a fee of $14.99
The fee to register and to use a domain name for one year
If this name is already registered
this form will be used to set up your web hosting and to
transfer your domain name to our web hosting services,
we will ONLY change the dns/nameserver information.
Your registrar will NOT be changed
and you will NOT be billed a fee for domain name registration
unless you specifically ask us to transfer your registrar using a separate form.

After you sign up on-line, a "Welcome" letter will be e-mailed to you
within a couple of hours. (except on weekends)

YOU MUST BE OVER 18 To Sign Up For Our Services
Pressing the submit button means that you are over 18

Domain Registration, Transfer, and Renewal fees are not refundable.

Submit request.

Clear form and start over.

Click Here To Go Back to Our Home Page Effective immediately customers will be charged $75 for any SPAM complaints from our upstream providers. NO Exceptions.

Click Here To Go Back to Our Home Page

Effective immediately customers will be charged $75 for any SPAM complaints
from our upstream providers. NO Exceptions.