If you have any questions, please call us toll-free at 1-877-525-HOST(4678).
Please write your domain name here:
www.__________________________________
_____ This is a new domain, and I wish Apollo to register for me.
_____ Years of Registrations x $12.95 per year = __________ TOTAL
New domains can only have the following extensions: .com, .net, .org, .biz, or .info. If you purchase a new domain name with a .biz or .info extension, you have to purchase it for 2 years.
_____ I already own this domain name.
Please choose a user login name: ______________________
This is what you will type in to access your account and cannot be changed. The user name must start with an alpha character in lower case, but can consist of numeric characters. It must be 4 to 8 characters in length. Your password is separate and will be emailed to you and you can change your password at any time.
Please circle the Billing Cycle for the Hosting Package you wish to purchase:
| HOSTING PACKAGE |
BILLING CYCLE |
||
| Annual |
Two Year |
||
| SHARED |
Value |
$95.52 |
$167.04 |
| Business |
$191.52 |
$335.04 |
|
| Ecommerce Pro |
$287.52 |
$503.04 |
|
| VPS |
Lite |
$383.52 |
$767.04 |
| Standard |
$479.52 |
$959.04 |
|
| Advanced |
$959.52 |
$1,919.04 |
|
| Premium |
$1,439.52 |
$2,879.04 |
|
Name (Last, First): ______________________________
Company Name: _______________________________
Address: ________________________________________________
________________________________________________
City, State, Zip: ___________________________________________
Country: ____________________________________
State (if other than the U. S. or Canada): _______________________
Daytime Phone Number: _________________________________
Fax: (optional) ___________________________________________
E-mail: __________________________________
Please provide an e-mail address below that does not use the domain name you are submitting. Or, if you only have one email address, you can use that address here too.
Second E-mail: ________________________________
How did you find out about us? ________________________________
Please include your check payment with this order form and put your domain name in the memo of your check.
Please include charges from both Section (1) and Section 2 above.
Please mail payment to the following address:
Apollo Hosting
2303 RR 620 South
Suite 135-301
Austin, TX 78734
I have read and agree to Apollo Hosting's Acceptable Use Policy. (Found at the bottom of any page on our Web site: www.apollohosting.com)
Signature: _______________________________________________