Site Host 4 U, Linux Web Hosting Provider

August 21 2008

Linux Web Hosting

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Account Activation Request

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By completing and submitting the form below you accept and agree to adhere to Site Host 4 U Policies, Guidelines and Disclaimer.

CONTACT INFORMATION:
(All fields with an asterisk* are required)

*First Name:
*Last Name:
*E-Mail Address:
*Address:
Address 2:
*City:
*State:
*ZIP Code:
*Country:
*Phone #:

ACCOUNT INFORMATION:

* Enter Desired Domain Name:	Examples: yourdomain.com or yourdomain.4ua.com if a subdomain Click here to check the availability of a domain name.
* Enter Desired Username:	NOTE: This must be 6 to 8 characters long. Usernames can not be changed once the account has been established.
*Front Page Extensions
* Status of this Domain Name:
If this includes new domain registration how many years do you want to pay?
* Choose Your Account Option:	NOTE:If this request includes a new domain name registration, add the amount for the number of years you've chosen to register your domain name to the above amount.
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.

BILLING INFORMATION:

* Credit Card Type:
* Credit Card Number:
* Expiration Date:
* Name On Credit Card:
* Billing Address 1:
Billing Address 2:
* City:
* State:
* ZIP Code:
* Country:
* Card Holders Phone #:	(Include Area Code)
Card Holders Email Address:

* How many months would you like to pay at a time:

NOTICE: DISCOUNTS DO NOT APPLY TO 25MB or 35MB ACCOUNT PLANS, RESELLERS, INDIVIDUAL RESELLERS, BULK RESELLERS, OR RESOLD ACCOUNTS.

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.

Additional Comments:

Once you have completed this request and submit it, your initial account will be setup within 4 hours. You will receive an email confirming setup, you may then utilize the Account Management Area to add accounts or nameservers (resellers only) to your account plan.

Please review this form before submitting. For security purposes, your remote address and user agent are traced through submission.