Blue 105 - Web Hosting and E-mail Hosting Order Form

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Blue 105 Order Form

Please read our service agreement, complete the following form by selecting the desired month's box corresponding to service you wish to order, review it and send it to us by clicking the submit button at the bottom of the page.

This is a secure form. All data is encrypted before being sent to our servers.

Domain or Sub Domain Name
(xyx.com or name.xyz.com):
Make sure the above name you want to register is absolutely correct. Click here if you need to register a new name.

Months	Service
3 6 12	Apache Virtual Server Account ($34.95/mo. $15 setup)

3 6 12	Apache Virtual Server Sub Domain Account (name.yourdomain.com) ($34.95/mo. $35 setup), $20 added for Sub Domain setup.

3 6 12	Five Email Accounts ($7.99/mo., $10 setup)
	Installer set forwarding to:

3 6 12	True pointing of domain names to one account ($7.99/mo., $10 setup)
	Name to point (e.g., xyz.com): Point to (e.g., zyx.com/pages/ or IP address or zyx.com):

3 6 12	Apache Virtual Server Additional Disk Space - 50Mb ($9.99/mo.)

Promotional Code:

Comments/Special Instructions	(If this is a FrontPage order, enter "FrontPage" below)

Billing
First Name:
Last Name:
Company:
Address:
City, State/Province:
Postal Code:
Country:
Telephone Number:	--
Fax Number:	--
E-mail Address:
Amount Billed:

AGREEMENT TO TERMS

I hereby agree to the above Service Agreement Terms and Conditions.

Selecting the "Send Order to Blue 105" button indicates approval of the services ordered above and agreement of our terms and conditions.

Click the "PayPal" button below now to complete this order.
You will be redirected to our payment processor PayPal where you will be asked to provide your credit card to complete the ordering process.
Please review the form with care. If you have any questions, please contact us.