Standard Plan Secure Order
Via Credit or Debit Card

 
Click Here To Check The Availability Of A Domain Name
(It will open in a separate window so you won't lose the info in this form)

Set-up is generally completed the same day and usually in less than one hour, but may take up to 24 hours depending on circumstances.  We will contact you after setup with a "Welcome" e-Mail which will include your account information and domain name server change information.

* Indicates a "Required" field.

Domain Information

 Your Domain Name*

www.  
NOTE: Be careful! No refunds for misspelled names registered for you.

* New Domain Registration   Don't register me (I will handle my Domain Registration)
New Registrations are $34 for TWO full years for: .com .net .org .us .info .biz

 Second Choice Name www.  
Only needed if this is a NEW registration and  in case 1st choice is not available.
Plan / Payment Choice*  
How You Found Us*  
If Found In A Search Engine
Please Tell Us Which One
Any Comments?
Additional Account Features
Do You Use Microsoft FrontPage Software?:*   
If you don't know what this is, you do not use it.
I Want A Shopping Cart:*   
More Info - osCommerce  | More Info - Super Shop Cart
I Want A Dedicated IP:*   
Required if you will have e-commerce or secure certificate.
I Want To KickStart My Site:*
Submit to over 400,000 engines
   More Info?
Do Not Overlook The Importance Of This
I Want SuperStats:*
Monitor hundreds of valuable stats for your site
   More Info?
Starts at $9.95 mo. and Depends On # of Page Views Each Month
Owner / Contact Information
First Name*  
Last Name*  
Company (If Any)
Nature of Web Site Content*  
Your Street Address*  
City*  
State*  
Zip Code*  
Country*  
Phone* Area Code and Phone:
Example: 555-555-5555
Mobile Phone Area Code and Phone:
Example: 555-555-5555
Fax
Your e-Mail Address*  
This MUST be an address outside the domain you are setting up.
Your Login info will be sent here.
Second e-Mail Address
If At All Possible

An additional address outside the domain you are setting up.
Helps us contact you if there is a problem
Credit Card Account Billing Information
Credit Card Type* MC VISA AMEX (Select One)
Card Number*  
Expiration Date*  Should your card be expired when a renewal of services are due, you authorize us to extend the Expiration date.
CVV2 Number*   What's This?
Name as it appears on Card*
Secondary Name on Card
e-Mail for Billing Receipts*  
Credit Card billing address must match Owner Info on above or be provided below::
Card Billing Address
City, State/Country, Zip   State      Zip  
Area Code & Telephone
Example: 555-555-5555
   
If paying by credit or debit card, I agree by submitting this order to allow The GraceNet to charge my debit or credit card an initial payment for web hosting services, either one month or one year of hosting according to the payment cycle selected and any domain registration fees (if applicable).  I also agree to allow The GraceNet to charge my debit or credit card monthly or annually on my account renewal date.  This agreement will be in effect until cancellation by either party in writing at least 10 days before the next account renewal date.

  If I am Applying As A Ministry or Church and Would Like To Be Listed On GraceNet's "Hosted Sites" Pages; I agree with the GraceNet Statement of Faith

By submitting this order form, you warrant that you have read and agree to our Terms of Service.

Submit this form ONCE ONLY