SIGN UP WITH E50 Welcome! Since 1994, e50 Web Site Hosting has provided high quality customer service, affordable solutions and the latest in web hosting technology. If you are looking for fast, affordable and friendly service you've found the most reliable, stable hosting company on the web. e50 offers you the ability to set up your own web site hosting, right now, online! By submitting the information below you are building your web site hosting service. All information is private and confidential and is secured when you submit this form. If you would prefer to call in your order, we can be reached via a number of contact points . We look forward to serving you and hosting your site! If you prefer, you can call us toll free and place your order over the phone, call: 800-386-6448 * Indicates required fields   *CHOOSE A PLAN Email Only [$6.95/mo.] Basic [$8.95/mo.] Standard [$19.95/mo.] Business [$29.95/mo.] Professional [$39.95/mo.]           *CREATE YOUR USERNAME & PASSWORD Your User Name and Password are used to access your account with FTP and for technical support reference. Username: (6-8 characters long. No spaces.) Password: (6-8 characters long. No spaces. Use letters and numbers. Use at least one non Alpha/Numa character such as $^# or _. Example: pa$$wo2d)   OR Check here and e50 will assign a password for you. *SUBMIT YOUR DOMAIN INFORMATION Domain: (6-8 characters long. No spaces.) Is it already registered? Yes    No    Not Sure   If your name is not already registered, e50 can register your name for you. We will put you as the registered owner and administrative contact. If you would like us to do this, check the box below and we will call you right away to help you. Yes, register my domain name for me IMPORTANT: If your domain name is already registered, please fill out these three fields [optional] to shorten your processing time: (if you do not know this info, or do not want to give it, leave blank). Registrar (ie: name of company that you registered your name with. Ex: Network Solutions, Register.com, etc.) Account#/User Name for Domain Name: Password for Domain Name:   If you are not ready to host, but would like to "park your name" with us, it is free. Either way, use this information if you register your domain name for our name servers: Primary DNS/Host NS1.E50.COM 206.117.177.100 Secondary DNS/Host COCO.E50.COM 206.117.177.11       *First Name: *Last Name: *eMail Address: *Billing Address: *City: *State: -Select a State- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *Zip: *Phone: . . Fax: . . Other Phone: . . General Comments or Notes:     Name on Credit Card:     Credit Card Type: Card Type MasterCard Visa Credit Card Number: Expiration Date: Month 01 - January 02 - February 03 - March 04 - April 05 - May 06 - June 07 - July 08 - August 09 - September 10 - October 11 - November 12 - December Year 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 CVV2: Status of your CVV2: Please Select One I have entered my CVV2 My card has no CVV2 imprint My cards' CVV2 is illegible   Date you want web site hosting to start: Today     On this date: I prefer to be billed and pay by check.     Which of the following do you need with your site (if unsure, leave blank): PERL ASP MS Access MS SQL 2000 Front Page Extensions Streaming Audio and/or Video Default Home Page Name will be: (if unsure leave blank, we will set it to be: index.html [standard]): index.html index.asp default.asp Other:   We will be giving you an administrative user name and password with your account to set up your email (POP or forwarding) via a web page control panel. This will be emailed to you shortly. By sending this information, you are authorizing e50 Web Site Hosting to set up your account and begin monthly billing. If any of the options or services you need change this price, we will notify you in advance. Please enter any special messages you might have for the staff at e50 Web Site Hosting. You will be contacted about any special needs or concerns you might have. Click the button below only ONE TIME please.

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