Website Hosting Order Form

Soltech Hosting Order Form

Place your order below and your account will be enabled as soon as your credit card is authorized. You will receive your username, password, and quick start welcome letter via email within 24 hours.

If you want to prepay for 1 year of hosting you will receive a FREE Domain Name.

We accept all major credit cards!

Customer Information

First Name
Last Name
Company
Please put your name above if there is no company name.
Billing Address
City
State
Zip Code
Country
Phone
Primary Email
Offsite or backup Email
Please repeat your email address above if you do not have a secondary email account
How did you find us?
Please do not change the following section unless you would like to fill in specific Contact information for the InterNIC registration.
Use the information above for the Administrative Contact information.
Use the information above for the Billing Contact information.
Have us be your Technical Contact.

Administrative Contact

First Name
Last Name
Company
Please put your name above if there is no company name.
City
State
Zip Code
Phone
Primary Email

Billing Contact

First Name
Last Name
Company
Please put your name above if there is no company name.
City
State
Zip Code
Phone
Primary Email

Technical Contact

First Name
Last Name
Company
Please put your name above if there is no company name.
City
State
Zip Code
Phone
Primary Email

Accout Information

Choose a User Name*:	(maximum 8 characters)
*The user name must start with alpha characters and consist of lower case alpha characters, numeric characters.
Account Type
Which Credit Card
Billing Frequency
Credit Card Number	e.g., 4123-4567-8910-1234
Expiration Date	/
Name on Credit Card* *Your Credit Card Name MUST MATCH your account Name.*

Domain Information

What is (or will be) your domain name? We can host ANY domain name extension. Please include .com, .net, .org, etc.	www.
This is a new domain. We can register any available .com, .net, or .org Please select the number of years for which you would like your domain registered ($25/year - save $10!).
I already own this domain name.

By clicking the "Submit Order" button below, you acknowledge that you agree
to and understand the terms and conditions of using our service.