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Place Your Web Design Order

To protect your privacy, we use highly secure order processing. This means your payment information is entered using a secure server and your credit card information is transferred internally using SSL, the most powerful encryption available.

To place an order, please complete the following order form. There are no hidden fees or setup charges.

Web Site Information
Domain Name
Layout #
Amount of pages

Contact Information

Contact Name
Company
Address
City
State/Province
Zip/Postal Code
Country
Tel. No
Fax No
Email Address

Billing Information

Visa

master card

American Express

Card Number	no spaces
Name On Card
Card ID Number

Expiration Date

Month

Year

Card Statement Address
City
State/Province
Zip/Postal Code
Country

We show & record your IP address
Credit card fraud is a felony and we will aggressively prosecute anyone attempting to misuse a credit card number.
We track every transaction and will use all means available to prosecute persons attempting fraud.
IF IT'S NOT YOURS, DO NOT USE!

Note: You should receive your new account information via email within 6 hours.
If you do not, please contact Support@OnTimeHost.Com.

By submitting this order, you agree to accept the OnTimeHost policies and guidelines



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