Silver N Gold Productions Fax Order Hosting

Silver N Gold Productions Web Site Order Form Email this completed Form to: support@silverngoldpro.com	Silver N Gold Productions 11500 Silver Cloud Trail Rogers, AR. 72756
Please write legibly and accurately:
E-mail..:
Name..:
Company Name..:
Street Address..:
City..:
State/Province..:
Country..:
Zip Code..:
Phone Number..:
Domain Name..: If new domain name, would you like Silver N Gold Productions to register the domain name for you? If new Domain, registering fee additional (To see for more info: http://silverngoldpro.com/hosting/domainname.html) Yes O No O
Web Site Hosting Plans: (Starting 06/29/2006) 100 meg site, Set-up $20, Monthly $8.97 O 200 meg site, Set-up $20, Monthly $14.97 O 350 meg site, Set-up $20, Monthly $19.97 O 650 meg site, Set-up $25, Monthly $29.97 O 1000 meg site, Set-up $25, Monthly $39.97 O If You would like a larger or "in between" hosting option please email us with your needs. support@silverngoldpro.com
*Additions: To save room on your site only install what is needed!
Will You be using Front Page and Front Page Extensions: ______________________________________ If No To the above what FTP program will you be using to access and modify your site: ___________________________________ If You do not Know the answers to the above please call or email us - so that we can be of assistance in this matter. 303-716-9734 Cell: 720-275-7718 support@silverngoldpro.com
CGI Scripts! Scripts do not have to be installed at time of ordering, may be installed anytime as requested by email! Web Site Manager O Form Mail O Guest book O Free for All Links Page O Simple Site Search O Anti-Spam O Hit Logs O Calendar O
Java Scripts! Scripts do not have to be installed at time of ordering, may be installed anytime as requested by email! Chat Touring O Navigator Ticker O Digital Clock O Other (please list) _______________________________
SSL Secure Server (No charge with 25 meg and above plan) $? (please request) but it is a one time only charge O
Additional E-mail accounts: 100 meg plan: 10..: 200 meg plan: 20..: 350 meg Plan: 25..: 650 meg Plan: 50..: 1000 meg plan: unlimited..:
Additional comments..:
Payment Type Visa O Master Card O Discover O American Express O Note: All credit card transactions will be done through our PayPal account. Icon: our account is to be found mark@silverngoldpro.com on PayPal listing. Check O (Make check payable to Silver N Gold Productions and mail to address given below)
Payment Options.: Monthly O Quarterly (5% discount) O Yearly (10% discount) O
Below information Must match your credit card billing address.
Card Holders Name..:
Card Holders Address...:
Card Holders City...:
Card Holders State...:
Card Holders Country...:
Card Holders Phone Number..:
Credit Card Number..:
Expiration Date..:
To complete your registration you must accept the terms of the Silver N Gold Productions Registration Agreement Located at: http://www.silverngoldpro.com/hosting/rulesandregs.html
I have read and accept the terms of this agreement. O
Signature..:	Date..:
Mailing Address, If paying by check Mark K. Doty P.O. Box 2146 Russellville, Arkansas 72811
Thank you for your order. We will be sending an additional e-mail to confirm your order to the email address listed above. You order will not be processed until we receive confirmation of your order either by return email or by phone.