Ellis County Texas Internet Service Provider

Local: 972.923.9090 - Toll Free: 1.866.923.9090 - Fax: 972.937.9998

- Webhosting Agreement -

This for must be completed AND SIGNED by the new customer and faxed to ECTISP at 972.937.9998

Date:

Customer/Co. Name:

Phone:

Address:

Suite:

City:

St.

Zipcode:

Contact Name:

Phone:

Tech Support:

Phone:

Bobby Kendrick, Kendrick Info. Tech.

214-773-7377

Website Address (

Has domain name been reserved by you?

If so, for how many years?

Exp. Date:

If you already have your domain name reserved, would you like to transfer it to our server?

(This makes it MUCH easier for us to manage your account!)

To transfer your domain name,

Email Address:

Username:

Password:

we will need the following:

If you do not have your domain name reserved, how many years do you want to reserve it for now?

(call ECTISP at the number above for specific pricing)

Credit Card Information

Card Type:

Credit Card No.

_____

Visa

_____

Mastercard

Name on Card:

Exp. Date:

Invoice Billing Information

Bill To:

Address:

Suite:

City:

St.

Zipcode:

Notes:

Your signature below indicates your approval to bill your credit card on a monthly basis. If you prefer to have monthly invoices sent directly to your office, your signature indicates your understanding that access to your website will be terminated 14 days after the due date on each bill and a process fee may be required to reactivate your account.

Please note: this monthly invoice will come directly from ECTISP (Ellis County Texas Internet Service Provider)

Customer Signature

Date