CCOL: WEB HOSTING SignUp Form

CCOL Web Hosting Order Form Date:    /     /

New Domain Registration

http://www. 1st Choice
http://www. 2nd Choice
Important: Please remember to include the domain name extension (.com, .net, .org, .biz, .info etc.)

Existing Domain Name

http://www.
Our domain is currently hosted with another company. I have already registered it and wish to have it point to CCOL DNS Servers

Official Contact Information for Domain/ Host Admin and Billing

Name:

Company Name:

Street Address:*

Address (cont):

Phone:

Fax:

Email:
for sending your login / billing information.

City:

Country:

Zip/Postal Code:

Hosting Plan & Server Plate Form (Please on your Selection)
Standard        Silver       Gold       Platinum
Standard        Silver       Gold       Platinum

Bank Cheque / Bank Draft for CYBER CITY ONLINE (1 Year Hosting Fee + Setup Fee + Domain Fee)
Amounting Rs Dated:         /        /
Checque/Draft # of Bank Branch

Authorized Signature                   Full Name                         Company Stamp

Print this Form and post it to: CCOL 333 St. 4 Margalla Town, Islamabad. Pakistan 44000

New Domain Registration
	http://www. 1st Choice http://www. 2nd Choice Important: Please remember to include the domain name extension (.com, .net, .org, .biz, .info etc.)
Existing Domain Name
	http://www. Our domain is currently hosted with another company. I have already registered it and wish to have it point to CCOL DNS Servers

Name:
Company Name:
Street Address:*
Address (cont):
Phone:
Fax:
Email:	for sending your login / billing information.
City:
Country:
Zip/Postal Code: