Offshore Web Hosting Request

Who are you ?

Independent Companion

Agency

Your Name

Email Address

Your Phone number

Your Home City

Country you are currently located in

Current or Previous website or Ad

Please check all that apply

I'd like you to handle transferring my website

I already own the domain to be used on the account

I'd like you to purchase/manage a new or additional domain for me

I currently use a domain email address with my old host

If approved, I'm ready to order immediately.

Select Offshore Web hosting Plans of your Choice

Monthly Hosting ($15)

Quarterly Hosting ($40)

Semi-Annual Hosting ($70)

Annual Hosting ($120)

Which setup option applies to you

FREE - Account Setup Only (no site transfer needed)

$30.00 - Transfer my existing website from a Previous Web hosting Company

Addtional information or questions you wish to include

Payment Method

When would you like to start your Billing Cycle ?

Soonest opening available

Anytime After Specific Date

Approximate date you'd prefer to start?

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