C I Corporation
Web Site Hosting Application

Instructions: Please fill in this form completely, including Administrative and Billing Contact info. We will send an invoice to this address.  Plus the domain registration will use this information to show that you are the owner of your domain.

Please review our Standard Terms and Conditions before continuing.

Do you agree to C I Corporation's Standard Terms and Agreements? If so, type "YES"

Desired Domain Name: www.
(Check here to see if domain name is available.)

Organization Info

Your Current Email Address:
Organization Name:
Address Line 1:
Address Line 2: 
City: State: Zip:
Country    

Is this a new domain? Yes No   - reather than a transfer of an existing domain hosted somewhere else

Do you plan to use Microsoft FrontPage? Yes No


Type of Account: Check here for information on standard plans.

Intro: Business Account: 50 Megabytes
Yearly Plan, $94.20 Annually (average $7.85/month) Save 10%!
Business:  $9.95 Monthly billing

Billing:

Visa- MasterCard- American Express- Discover- Diner's Club- Invoice-

Please Note: Credit Card Accounts are billed monthly or annually, and Invoice accounts are billed only quarterly. 
Invoiced accounts will not become available until payment by check is received.

Account Number:  
Expiration Date (MM/YY)
Name as it appears on your card:

Click here for remittance address if paying by check

Additional Account Info: Each account requires a master account login and password. this Login and Password will be used for POP email and ftp. All mail going to your domain name not directed to a POP account below will be forwarded to this POP account.

Please choose your desired Login Name in lower case characters and/or numbers.

Login Name: Password:

The Login Name, by default, will be your POP email account name. If you would rather have the convenience of forwarded mail, fill in an address below.

Forward all mail to:

Please tell us how you found out about C I Corporation:

Additional Email POP accounts (May be left blank for now, or you can add more later):

Email #2: Password:
Email #3: Password:

Additional Comments/Instructions:

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