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Web Hosting Service Application

Hosting accounts are activated within 48 hours after ordering

STEP 1
Domain Name:

Already Registered / Have a Domain Name
New Domain
WWW.
Extension: (examples: mydomain, my_domain, my-domain)




STEP 2
Your Hosting Plan Information
There are no set-up charges on new hosting accounts.

Hosting Plans:
Basic: $14.95 / month, 3000MB of storage More >>
E-commerce: $89.95 / month, 5000MB of storage, includes single store license of Miva Merchant 5.5, More >>


STEP 3

Personal Information

First Name:
*
Last Name:
*
Email:
*
Business Name:

Where did you hear about us?

Address Information
Address:
*
City:
*
State:
*
Zip:
*
Country:
*
Phone:
*
Fax:



STEP 4
Payment Information

Please select a term:
Monthly Billing Quartery Billing (every 3 month) Annual Billing (12months)

We accept payments in the form of a Check, Money Order, MasterCard, Discover or Visa.

For check or money order transactions, you are asked to send payment for the first (1) month of service.
Your account will be activated on receipt of payment.

If paying by check, please make payable and send to:
Tinker Graphics & Marketing
112 A. West New York Ave.
DeLand, FL 32720

For credit card transactions you will be charged for the first (1) month.
Your account will be configured within 24 hours of submission of this form.

Pay via MasterCard / VISA / Discover
Pay via Check / Money Order
If you are paying via credit card, please provide your credit card information below.
This is a SECURE ORDER FORM
Card Number
Expiration Date
Month: Year:
Card Holder Name:
Card Statement Address:
Card Statement City:
Card Holder State:
Card Statement Zip:
Card Statement Country:


By continuing to send this form you are agreeing to the
charges and terms as defined above and in our hosting policies.

386-734-3475
Email: support@tinkerwebdesign.com

* required