spacerhomeabout usspacersupportspacerresellersspacercontact usspacersite mapLinksLogonspacer
webhostingEcommerceBiz toolsOrderChat RoomForumDeveloper Resource  


Step 1

This online order form is being viewed under a secured environment. Information sent from this form is sent through a secure socket layer for your protection. You will receive your Account Activation e-mail within four to eight hours of submission. Your IP address, username, password and additional information will be included.

* Required Field

First Name*:
Last Name*:
Zip/Postal Code*:
Telephone Number*:
(We verify the number) (We verify the number)
Alternate Number :
Fax Number :
Current E-Mail Address*:
Where Did You Hear About Us?*:


Domain Name*:
Domain Status*:

(1) If you choose to have us register your domain name, tell us for how many years:

Click Here to review pricing.

(2) Fill out the next three fields if you choose to have us transfer your domain name.

Where did you purchase your domain name?:
Registration Account Number/Username:
Registration Account Password:


We do not host Adult, Warez or Spamware sites.


Account Type*:
Billing Cycle*:
All Monthly Budget, Standard, E-Commerce  and Custom Plans must be paid for by credit card.
Account Password*: (alphanumeric, 6-12 characters long)
Re-Type Password*: (alphanumeric, 6-12 characters long)


Account Additions:
FrontPage Extensions (Free - use only if site was designed with FP)
Secure Sockets Layer (SSL) - $5.00/mo or $55.00/yr (Gold Plan Only)
Webtrend Site Statistics - $5.00/mo or $55.00/yr
Golemweb Deluxe Forum - $7.00/mo or $77.00/yr
Additional Comments:




Payment Method*:

Credit Card Type*:
Credit Card Number*:
Expiration Date*: Month Year
Full Name On Card*:
Issuing Bank*:



By typing your name in the "Online Signature" below, and pressing the "Order Now" button below, you hereby agree to the Terms and Conditions of Use and hereby authorize all expenses associated with this account. Additionally, any monthly, quarterly or annual charges are authorized to be billed, when due, to this account. Your IP Address is recorded to help prevent Internet Fraud.
Online Signature*:  
Recorded IP Address:  



                                                                   GolemWeb | Development | Hosting | Support | Showcase | Contact | Web Email
                                                                                                                                Copyright 1999 - 2001 Golemweb.Com
Privacy  Terms of Service
                                                                                                                                                    All rights reserved.