Virtual Hosting Orders

Please fill out this form for Virtual Hosting orders.

You will be contacted immediately.

If you have any questions please call 1-888-884-2075.

I. Select your Virtual Hosting Plan

Ultimate
500 MB Space
Setup fee: $50
Monthly: $200
20 GB included
Bandwidth: $5.00 per GB
Free 24/7 Support
Whopper
300 MB Space
Setup fee: $50
Monthly: $150
15 GB included
Bandwidth: $5.00 per GB
Free 24/7 Support
Extended
200 MB Space
Setup fee: $50
Monthly: $75
10 GB included
Bandwidth: $5.00 per GB
Free 24/7 Support
Personal
100 MB Space
Setup fee: $50
Monthly: $50
5 GB included
Bandwidth: $5.00 per GB
Free 24/7 Support

II. Company or Client Information

Company or Name*:
Address*:
 
City*:
State/Province*:
Zip/Postal Code*:
Country*:
* required

III. Main Contact Information

Name*:
E-mail*:
Phone*:
Fax*:
* required

IV. Technical Contact Information

Name:
E-mail:
Phone:

Please Indicate the primary domain name for your server:


Comments or specific instructions:


Please print the following file and fill it out.
The credit card bearer must sign and return this form via e-mail or fax to: 1-(503)-212-8451
You must also read and sign our TERMS AND CONDITIONS and return it by fax.
If we do not receive these forms, we will not set up your server!

I undersigned, ____________________________________, authorize ParadoxWeb

to charge my VISA/MASTER CARD number _____________________________,

expiring on ____________ (month/year) for the base amount of ____________ USD

every month starting on ______________/2001.

This agreement may be canceled at any time by written notification.
Any month started will be due in full. I declare to be the bearer of this credit card.
I am aware that the first charge will include the setup fee of my virtual hosting plan
plus the monthly fee of the plan I selected. Bandwidth charges may occur at the rate
of $5.00 per GB transfered. This amount will be debited from my credit card as well.
In case of litigation, the logs provided by ParadoxWeb will be the only ones to prevail.
I acknowledge the this document acts as a contract binding me to ParadoxWeb and may
be used for legal purposes.

Date:                               Signature of the bearer: