NC METRONET

Web Services Order Form

* Indicates Required Field

Web Site Plan
Domain Name * New   Existing
Domain Name *
Web Site Hosting Annual Charge
Web Site Features
Will you be using Active Server Pages? (1) Yes  No
Will you be using Microsoft Access?  (add $10.95 Setup Fee) Yes  No
Will you require Web Trends web site statistics?   (add $19.95 Setup Fee) Yes  No
Subscriber Information
First Name *
Last Name *
Company Name
Address #1 *
Address #2
City *
State/Province *
Zip/Postal Code *
Country *
Telephone Number *
Fax Number
E-mail Address * (dial-up account)
Order Confirmation and Billing
It is not necessary to provide us with any payment information at this time.
You will be contacted by email using PAYPAL our secure payment partner to confirm your order and process billing. 

(1)  All ASP's provided by customer must be approved by NC Metronet before they may be used.


By clicking on the 'Order Now' button you are agreeing to the terms stated in the
SERVICE AGREEMENT TERMS & CONDITIONS

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