Order Form

This form is only used for domain registration.
To order a new domain and hosting service together, please use a different form at
http://springweb.com/contract.shtml

Name:
Contact E-Mail:	Important Note: Please provide us your current e-mail address. This email will not be updated to your domain registration. This only be used for our own record. To update your admin email, please login to your domain manager and change the admin email there. Please make sure that it is correct.
Company:
Street Address:
City, State, Zip:	,
Country
Phone:	(please remember area code)
How did you find out about us?
Domain Name Registration Register Renew
Please note: Springweb will charge your credit card for Domain Name Registration at the time of registration. The domain fee must be paid by credit card only. The Domain Name Registration fee is non-refundable. Please make sure your domain name is correctly spelled. Domain name
Enter a description of your organization (personal or business)
package/plan choice .com, .net, .org, .biz, .us $20 One year Domain Name Registration fee $38 Two years Domain Name Registration fee If you will host your site elsewhere, please provide us with your hosts primary and secondary server names: Primary server name Secondary server name
Comments
Payment by Credit Card

Visa	MasterCard
Visa Debit Card	MasterCard Debit Card

Name as it appears on the card:
Card number	:Please make sure that it is correct.
Expiration date:
For security purposes, you can help to prevent fraudulent credit card use by providing us with correct information regarding your Credit Card Billing Address (your address that the bank bill you each month), Zip code and Customer Service 1-800#. We will not provide our service if the address and zip code don't match the original card holder information. We appreciate your help.
Credit Card Billing Address
Credit Card Zip Code:
Credit Card Customer Service Tel. # (on the back of your card)

Please expect your domain to be recognized on the web within 2-5 days