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BUSINESS eMAIL HOSTING ORDER
AFFILIATE INFO
Affiliate Business Name + Franchise # (if applicable)
*
Your Name
*
eMail
*
Phone
*
ABOUT YOUR CUSTOMER
Company Name
*
Domain
*
SELECT eMAIL HOSTING PACKAGE
Select Type of eMail Hosting
*
SELECT TYPE
Premium Business eMail Hosting
Enterprise eMail Hosting
Number of eMail Addresses Needed. (Cost is per Account / Monthly)
*
Price:
$4.00
Quantity:
Number of eMail Addresses. (Cost is per Account / Monthly)
*
Price:
$12.00
Quantity:
MONTHLY COST (Billed To Affiliate Account)
MONTHLY
$0.00
BILLING FREQUENCY
*
SELECT
Monthly Billing
Quarterly Billing
Thank you! We appreciate your Business.
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Remit
:
P.O. Box 77163
Charlotte, NC 28271
support@bigheadwebhost.com
p. (980) 800-9950
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