Pro WEB SITE Order Form

1. Go to the print command and print this page. Fill out the order form and FAX to
1-806-894-8764.
(or)
2.Go to the print command and print this page. Fill out the order form and mail to
Advanced Concepts, P.O. Box 16248, Lubbock, TX., 79490-6248.
Please send check, money order, or credit card information. Make check or money order payable to Advanced Concepts.


Enter the domain name you want to use for your website. Your domain name should be 16 characters or less and end with .com, .net, .org - shorter names are recommended.


WEBsite Information
Please check or otherwise indicate which WEBsite package you desire. Please remember that you can always upgrade to the larger packages and receive a full refund for all unused portions of your package. The unused portions are calculated on a monthly basis.


Self Service Website

Select payment plan type:
12 Months Pre-Paid $348 (no setup fee)____

Standard WEBsite

Select payment plan type:
$49 Monthly Plus $100 Initial Setup____
12 Months Pre-Paid $488 (no setup fee) - YOU SAVE $200____

Executive WEBsite

Select payment plan type:
$69 Monthly Plus $200 Initial Setup____
12 Months Pre-Paid $728 (no setup fee) - YOU SAVE $300____

Corporate WEBsite

Select payment plan type:
$89 Monthly Plus $300 Initial Setup____
12 Months Pre-Paid $968 (no setup fee) - YOU SAVE $400____

Webmaster WEBsite(tm)

Select payment plan type:
$289 Monthly Plus $500 Initial Setup____
12 Months Pre-Paid $2968 (no setup fee) - YOU SAVE $1,000____


Order Form

Your Name:_____________________________________________________________
Company Name:_________________________________________________________
Phone Number:__________________________________________________________
FAX Number:____________________________________________________________
Street Address:__________________________________________________________
Mailing Address:_________________________________________________________
City:___________________________________________________________________
State and Zip Code:______________________________________________________
Country:________________________________________________________________
Email Address:___________________________________________________________
Credit Card and Account Number:____________________________________________
Credit Card Expiration Date:_________________________________________________
Cardholder's Name:________________________________________________________
Signature of Cardholder:____________________________________________________
Where did you find us?:_____________________________________________________
Which Search Database?:___________________________________________________

For your records and ours, the OFFICE ID# for this order is W8.

If paying by credit card, fax or mail this completed form, the Internet Domain Name Registration form, the Internet Web Site Service agreement, and the Activation of Domain Name Services form to P.O. Box 16248, Lubbock,Tx., 79490-6248.

If paying by check, mail this completed form, the Internet Domain Name Registration form, the Internet Web Site Service agreement, and the Activation of Domain Name Services form to P.O. Box 16248, Lubbock,Tx., 79490-6248. Make check payable to Advanced Concepts.

Please be aware that the InterNIC will invoice you directly for an initial registration fee of $100 which pays for two years of registration.

We appreciate your business, and we will strive to provide to you the very best in quality and service.

Please feel free to contact us at any time.

Your Comments_____________________________________________________________
______________________________________________________________________________


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