EziHosting Web Hosting Order Form

Congratulations!!!

On your decision to host with EziHosting.

Just fill out the form below and we will have you up and running in hours.

Your Domain:
Contact E-mail:
Hosting Plans
Monthly Payment Plans
Amount
Month(s)
25 Mb (Per Month) $19.95 / month
Month(s)
50 Mb (Per Month) $29.95 / month
Month(s)
150 Mb (Per Month) $39.95 / month
Month(s)
500 Mb (Per Month) $49.95 / month
Yearly Payment Plans*
Amount
Months
25 Mb (Per Year) $219.45 / year*
Months
50 Mb (Per Year) $329.95 / year*
Months
150 Mb (Per Year) $439.45 / year*
Months
500 Mb (Per Year) $549.45 / year*
2 Year Special (limited time only)
Amount
Months
500 Mb (2 years) $549.45 / 2 year*

* Get 1 free month of web hosting on any 1 year contract. Pay for 11 months and get a full year!
(Business) Name:
Contact Person:
Street Address 1:
Street Address 2:
City or town:
State or Territory:
Post Code:
Country:
Phone Number:
Fax Number:
Comments:
How did you find us?
What Search Engine?
Credit Card Authorization:

(Credit Card Authorizations can be cancelled at any time!)

After you click on the "Confirm Order" button, you will be taken to a SSL Secure Payment Page where you can finalise your order.

If you do not want to use your credit card or you don't have one, then just print this completed form and post it with your cheque or money order to:
EziHosting Pty Ltd, 2041 Channel Highway, Electrona Tasmania 7054

Credit Card Fraud will be prosecuted!
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ezi-hosting.com
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Your IP:
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