HOSTING ORDER FORMThis form is for hosting ordering only! If
you would like a website built and hosted, please click here for a free quote.
Domain Name Registrants Benefits and Responsibilities
Business name you want us to register your domain name under.
State you live in?Select StateAlabamaAlaska
KansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington D.C.
West VirginiaWisconsinWyomingOutside US
Your Zip Code?
Your E-mail Address? Please Double Check It. Need it to get back with you! :-)(e.g.: email@example.com)
Do you have a Domain name now? Yes or No
If So, What is your Domain name?
Would You Like Us To Transfer the Domain name? Yes or No
If you need a Domain name, what name would you like us to register for you?
Do you want to “PARK” this domain, until you are ready for a web site? Yes or No
Which size hosting plan would you like to purchase?
Have you read our Acceptable Usage Policies? Yes No
Do you have any other comments?
How did you find us? What Search Words? (Very Important To Us!)
Did you provide a correct E-mail address above?
To send to Blais Web Creations,Thanks for your time!
Martin BlaisStanton, Ca. 90680
Copyright© 1998 - 2016, All rights reserved to Blais Web CreationsHosted by BWC Hosting