Secure Order Form

Your Access IP address is:

Name:

Contact E-Mail:

Important Note: Please provides us your e-mail address from your access provider. We will not except generic free e-mail address such as hotmail.com, iname.com, usa.net etc. Thank you for your cooperation.

Please make sure that it is correct.

Alternative e-mail address.
Registration E-mail: This is the e-mail you have selected for us to register in your domain registration.

Company:

Street Address:

City, State, Zip:

 ,
Country:

Phone:

 (please remember area code)
How did you find out about us?

 

Hosting Options:

Please select ONLY ONE choice from the following: 
 1. New Domain
 2. Existing Domain (Transferring a Domain)
 3. Sub-domain (Existing clients only)
 4. www.yourname.springweb.com

 

  New Domain

 Important! Please be sure to check domain availability before placing an order for a new domain. If you order a new domain without checking and the requested domain is unavailable, you may experiece a definite slow down in the process of setting up your site.

Foreign Domain: Most foreign domains required the registrant to register the domain. We will provide you with our DNS name server to register your domain after we setup your site. Please make sure that the domain is available before placing an order.
Enter requested domain name

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. If you want to pay for hosting package by check, that's fine but you still need to provide us with your credit card information for Domain Name Registration. The Domain Name Registration fee is non-refundable. Please make sure your domain name is correctly spelled.


$25 One year Domain Name Registration fee
$48 Two years Domain Name Registration fee
Enter a description of your organization (personal or business)

Existing Domain
Fill in your domain name that you want to transfer to our server.  

Sub-domain (Existing clients only)

.

Example: name.yourdomain.com

www.yourname.springweb.com

(co-domain with springweb only)

 www..springweb.com

Package plans
Initial package/plan choice (See service page for more details)
Do you need Front Page Extensions (free)  Yes No
Real Audio/Video $10/month (Free for Gold account)  Yes No
Volano Chat (add $12/mo)  Yes No
Total Due  $(including domain registration fee) Please note: * $ = US Dollar
Comments:

You acknowledge that you agree to and will abide by our policies?

 

Payment Options

 Credit Card

  Check Drafting

Customers outside the US, please pay by credit card only.

Questions: hosting@springweb.com

 Credit Card

 Visa  MasterCard

 Call me please
 Visa Debit Card MasterCard Debit Card

Name as it appears on the card:  
 Bank Name  
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 (first line of your address):  
Credit Card Zip Code:  
Credit Card Customer Service Tel. # (on the back of your card)  

  Checking Account Information
Fill in the appropriate information as if you were writing an actual check. Sending us the paper copy is unnecessary. If you have questions on this, please e-mail us at hosting@springweb.com

 Enter your name and address as on your check 


Check #   

(We will start with check # 1001 for the first month, #1002 for the second month and so on )
Enter your phone number 
Pay to:  SpringWeb $ 

  Bank Name/Address
Name
Address
,  
City, State Zip

Enter the routing # from the bottom
left of your check here (9 digit number):

Bank Phone
-

 

 

 

Your Bank Account Number
(include spaces or dashes):

Memo:
Sign with your E-Mail Address:

Important! Please make sure that the information above is correct before submitting this form. Returned checks are subject to a $10.00 non-sufficient fund fee.

  You must check here to accept the following terms. (Without the acceptance, we can not proceed your request)

I agree to allow Silver Palace International LLC (SpringWeb) to draft my check or charge my credit card an initial payment for internet services which includes the initial package price plus a one-time setup fee. I also agree to allow Silver Palace International LLC (SpringWeb) to draft my check or charge my credit card monthly for the service packages and monthly at the renewal price for the other packages after the initial package duration has expired. I understand that I will be contacted via e-mail one week prior as a courtesy before renewal drafting commences, for any service package I have chosen. This agreement will be in effect until cancellation by either party in written notice at least 7 days before the due date.

Accounts are generally setup within 24 hours

© 2000 Silver Palace International LLC

 SpringWeb

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