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Website Signup

Customer Address
Name:  
Company (optional):  
Address:  
Address (cont.):  
City, State, Zip:    
Telephone:   () -
Fax:   () -
E-mail:  
Bill to this address?   Yes   No
DCANet Customer ID:
(existing customers only)  
Billing Address (If different than above)
Name:  
Company (optional):  
Address:  
Address (cont.):  
City, State, Zip:    
Telephone:   () -
Fax:   () -
Website Package Information
Website Packages:
  • Linux Website: Standard Linux Website: 2GB storage - $15.00/month
  • Additional Storage: Additional storage in 1GB increments for existing web hosting account customers - $5.00/month
Select Package:  
Website Name
(usually your domain name):
Amount of storage
space to add:
GB at $5.00/GB per month
Password:  
Retype Password:  
Please enter any additional comments below:
  

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