Bestwebs New Customer Information Form.
Desired account?
Value $23.95/month
 Starter $34.95/month.
Personal $49.95/month Business $69.95/month
Full name ?
  

Email address?
 Business name?
Please describe your organization (or yourself!).

Install Frontpage ext.
Java Chat $7.00/month.
Real Audio/Video $5.00/month.
 Mailing & Contact Information.
Street address (1)?
 Street address (2)?


City?
 State?


Zip/postal code?
 Country (2 letter Code)?


Phone number?
 Fax number (if applicable)?
 Domain Name Registration.
 
Create a new domain name?
 Move domain to Bestwebs.com?
Yes.
 Yes.
Domain name (1st choice)?
 Domain name (2nd choice)?
Please note that InterNIC will bill you directly for a NEW Domain name registration.
The current registration rate is $70.00 which covers the first 2 years and $35.00 per year thereafter.
The InterNIC registraion fee must be paid within thirty days of domain activation.
There is no additional charge if you transfer an existing domain to our server.
 Payment Information.
Bestwebs.com accepts payment in the form of a check (or money order) as well as by Mastercard or VISA.

For credit card payment, you will be charged on a quarterly basis for the first 3 months plus $49.00 one time setup; You will then be billed every 90 days from the activation of your Web presence for the upcoming 3 month's service.
Your account will be configured within 24 - 48 hours of the submission of this form.
Pay via Mastercard/VISA?
 Pay via check/money order?
Yes. Yes.
For check or money order payment, you are asked to send payment for the first three months of service plus 49.00 one time setup; You will then be billed every three months for the upcoming quarter's service. You will be activated on receipt of payment
 Credit Card Information.
If you are paying via Mastercard or VISA, please provide your credit card information below.
Card Number?
 Expiration Date?


Card Holder Name?
 Card Holder Address


Card Holder state?
 Card Holder zip?


 Mailing a Check or Money Order.
Please make checks payable to "Computer Wizard" and mail to the following address:
Computer Wizard
Attn: Carl Macaluso
1800 Embassy Dr., #123
W.P.B., Fl. 33401
 
Thank you for your interest!

 
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