Web Hosting Order Form

Web Hosting service sign up only. No domain registration.

Your Domain Information

Domain Name:

example: companyname.com

Hosting Plan

Pricing | Features

Bronze	$36.00/year	50 MB Hard Drive Space/5 Email Accounts
Silver	$72.00/year	100 MB Hard Drive Space/10 Email Accounts
Gold	$144.00/year	200 MB Hard Drive Space/20 Email Accounts
Platinum	$360.00/year	500 MB Hard Drive Space/50 Email Accounts

Your Information

Name:

Company Name:

Address:

City:

State:

Zip:

Country:

Phone:

Fax:

Email Address:

Survey and Comments

How did you first hear about PhotographyHost?

If you used a search engine, please indicate the search term(s) you used to find us:

If you were referred to us by a current customer, please indicate who referred you:

If you spoke to a sales representatives, please provide their name: