Web Site Hosting Registration

Information supplied should be that of the person responsible for the payment of the account. Fields indicated with a "" are required fields.

Contact Information:
Name
Address 1
Address 2
City
State (or Other)
Zip Code
Country
Province
Email
Alternate Email
Your alternate eMail should be one that is not affiliated with your web site but also one that you check on a regular basis. It's a secondary contact for us to reach you if need be. Example: Should we unexpectedly experience server trouble, we then cannot contact you via your site eMail. Your account cannot be activated without a secondary email address.
Phone
fax
Referral & Helpful Information
Referred by
Referral eMail
We'd like to thank this person for referring you and advise them of their free hosting opportunity!
How did you find us?
Which Search Engine?
Words or phrases you used to search?
I'm interested in the FREE Hosting Program!
	Yes No
Learn more about FREE Hosting - page will open in a new window - you will not lose your form entries.
Check the box if you would like to display a text or image link to the Digital Mouse Designs web hosting services in a non-obtrusive place on your web site? This link is generally placed in the footer of your site and simply indicates who your web host is.

Important Information

By submitting the registration form you are indicating that you have read, understand and are agreeing to all terms of all other Terms and Conditions set forth for hosting on our servers, including the Billing Policy. Should you wish to review them, links to all policies are below.

Review Our Policies

Continue Registration

Both columns must be completed in order for us to process your request. Fields indicated with a "" are required fields.

Web Site Information :
Web Site URL or Domain Name — necessary to activate the account on the server
http://www.
Business Name or Personal Site — if it's a non-business personal site, enter "personal"

Brief description of site content and/or product(s) for sale on the site. A sentence or two is generally enough information.

Hosting Plan selection is handled on the Payment page when you purchase your service. Click the link above to review the plans if you wish. The page will open in a new window. You will not lose your form entries on this page.
Contact us for cost before submitting your registration if you need a custom hosting plan.
Front Page Site?	Yes No
Select "Yes" only if your site is created with Microsoft Front Page, otherwise select "No."
Designer Name
Designer eMail
Additional Options
You will have the option to select from the following additional services at the time you pre-pay your hosting.
Search Engine Optimization - pricing varies depending upon the plan you select.
New! Automatic Back Up Peace of mind at an affordable cost!
Select Your Payment Options

Payment Plan
Annual Payment Plans are discounted 5%
Payment by
Payment Options may be changed at a later date. Simply advise us which plan you would like your account change to.
Any comments or special needs?

SPAM STOPPER: This form will reject as spam any instance of http:// or https:// entered into it's fields.
I have read and agree with all Terms, Conditions and Policies including the Billing Policy. I understand that violation of any Policy may result in additional fees, suspension or termination of my account.

You will be directed to our pre-payment page upon submission. The page explains how the pre-payment works, allows you to review the summarized hosting plans so you can make your plan selection and then proceed to the payment page.

Most generally accounts are set up within 12 hours. Should you not receive your Welcome Letter containing your account information within 24 hours, please inquire.

We will respect your privacy. The information you submit will be used solely to contact you. We will not share your information with any third party.