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Web Services Order Form



Your Domain Name  Specify the Domain Name you want Servanthost to host. If you have not yet decided on a domain name, click here to check on the availability of your desired domain name.  Valid domain names look like: servanthost.com, vitalresponse.net, etc.

If you have not already done so, you can reserve your own .com, .net, .org, .us, .info or .biz domain for around $10 per year through GoDaddy (or any other Domain Registrar you prefer).

Domain Name:    http://www.

Domain Name Registration Options 
If you have not yet reserved your desired domain name, we can do it for you. Or you can choose "Take Care of It Yourself" if you already own the domain name or if you would like to register it yourself.

Please Purchase This Domain Name For Me

ServantHost will register the .com, .net, .org, .biz, .info or .us domain name specified above for you with GoDaddy for the number of years indicated below.  The charge is $19.95 per year (minimum 2 years initial registration period). 

We will use the "Organization" you specify as the "Registrant Name" for the domain or your First/Last name if no Organization is indicated, below.  

Please click here to check that the desired domain name is available. 

Number of years for which you would like this domain registered: 

           Please double-check your domain name spelling.  
           Domain Name reservation fees are NOT refundable.


I Will Take Care of This Myself

Make this selection if you specified a Domain Name which you already own or when you want to handle the Domain Name registration yourself.  In either case, you will need to adjust your domain's "Name Server" information as follows:

        Primary Nameserver:  ns1.servanthost.NET 
    Secondary Nameserver:  ns2.servanthost.NET 
 
Web Hosting Package  
Specify which web hosting plan you are ordering.  Also, please let us know how you heard about ServantHost.

Web Hosting Plan:  Paid 

How did you hear about ServantHost? 

 
Referred by a Friend ?
 Please indicate their Name or website so we can thank them.

 
Select Your SiteBuilder Option 
Most Plans include a Trellix SiteBuilder account. Please indicate if you want the Sitebuilder activated. The eCommerce Catalog Manager option is also available to help you build, maintain and sell virtually any product from your own web store!
 
SiteBuilder Plan:

Billing Information 
The address given should be the mailing address at which you receive your credit card statement.  Incorrect or incomplete Contact information will cause account setup and notification delays.

First Name:
Last Name:
Organization:
Billing Address:
2nd Address Line: 
City:
State:
Int'l Province:
Zip/Postal Code:
Country:
Daytime Phone:
Fax:
E-mail Address:
Additional information and instructions will be sent to this e-mail 
address.  Please ensure that it is correct. If possible, avoid specifying
a free e-mail service address (such as yahoo.com, hotmail.com, etc.).
Off Network
E-mail Address:
Please enter a different e-mail address to provide us
with an alternative way to contact you, if possible.
Any valid e-mail address is acceptable here.
Terms and Conditions
Read the Terms & Conditions.  If you agree to them, check the box and press the "Continue" button below.

I have read and understand the Terms and Conditions and I agree to abide by them.   (IP: 54.234.126.92)

If you have questions or encounter a problem, please call our 
toll-free support line at (800) 234-3862
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