PRE-PAID CONTRACT FOR WEBHOSTING

Important:

  • This form is not for new customer use. It can only be used to pre-pay an existing phpwebhosting.com account.

  • If your account is currently past due, please add the appropriate past due amount to your payment. Your balance can be found under the billing section of your control panel.

  • If your account is currently past due and your site has been disabled, please let us know you are sending payment and we will re-enable your site as a courtesy while we wait on your check. You can send us a message via the help desk section of your control panel.

Instructions:

Please fill this form out on your computer, then print. If you decide to complete the form manually, please write
carefully - if we cannot read your contract, we cannot process it!




(customer name)

phpwebhosting.com Payment Processing
P.O. Box 4476
Indianapolis, IN 46082-4476
U.S.A.

___ Enclosed is $59.70 U.S. Dollars payment for 6 months of webhosting.
___ Enclosed is $119.40 U.S. Dollars payment for 12 months of webhosting.
___ Enclosed is $238.80 U.S. Dollars payment for 24 months of webhosting.
___ Enclosed is $ U.S. Dollars for past due balance

I understand that my payment will take effect upon my next monthly
payment date and will replace any current credit card billing arrangement.

Please apply my payment to my account named:


Your phpwebhosting.com username (not your domain name)

I understand that this contract cannot be cancelled and that refunds are only
made during the first 30 days of hosting.

I understand that this contract expires at the end of the term selected above and that
the contract will not automatically renew.

Signed:

___________________________________________
(printed name)

___________________________________________
(signature)

___________________
(Date)


(Contact Email Address)


Print this form out and send the completed form along with full payment of
in U.S. Dollars to:

phpwebhosting.com Payment Processing
P.O. Box 4476
Indianapolis, IN 46082-4476
U.S.A.

Payment can be made by Check or Money Order. No cash please.

Please allow 7-14 days for checks to be processed.


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