We must receive  payment in our office before any transactions will begin.

ACCOUNT INFORMATION:

  Name/Company Name: required
Contact Name:
   (If different from above)		 required
Address: required
City required
 State required
Zip: required
Country required
Billing Contact:
   (If different from above)		 required 
Address:
City
 State
Zip:
Country
Home Phone: required
Work Phone:
FAX
E-mail: required
TYPE OF ACCOUNT:
   
  Domain Account:  For Domain accounts only
Domain Name:
Already Registered : Yes   No
Would you like NETCON3 to
Register your Domain for you?		 Yes   No
 Monthly billing type: 
E-Mail Monthly  *Snail-Mail Monthly Invoice:
      * (Additional $1.00 per month fee)

All fees are per month. All invoices are due by the 1st.  Any payments received after 
the 5th of the month will be assessed a $5.00 late fee, no exceptions!
Web Hosting Packages: 

Please indicate which package you want
(select only one package per form )
  AGATE:     $10.00  10 mb of disk space.
3 e-mail accounts, e-mail forwarding
FrontPage extensions, ASP, CGI
  RUBY:          $25.00 25 mg
10 e-mail accounts, e-mail forwarding
FrontPage extensions, ASP, CGI

$25.00 one-time set-up fee is required on all packages and transfers.
  Web Site Development
Click here for details		  
 
Yes No
 I have read and agree to the terms and conditions of the service agreement:
  (service agreement)
 

Last update: 04/23/2008