Gryphyn Media web hosting - Philapdelphia PA
Hosting for people that know a thing or two.

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ALERT! If you cannot or do not want to use Paypal, use this form. We can also take a credit card by telephone, or a mailed check.

Domain name to be hosted

Hosting Account Level (Click one)

Do you need us to register the domain name for you?
No, I already registered it. (Registrar: )
Yes, register it for $15/year, and bill me to renew it with my annual hosting account renewal.
I already own it, but I want to transfer it to you from my current host/registrar for $15/year.

Do you need any or all of these?
FrontPage Extensions ($12/year)
Static IP ($36/year - to support SSL certificate use)
I want to use the shared SSL Certificate to have secure pages (no charge)
Purchase an SSL Certificate for me (we will get back to you on price)
I installed an SSL Certificate I already bought (no charge)
Host a Miva Merchant license I already own

Your name

Who are you?
I am a consultant buying hosting for a client's site
I was sent to buy hosting by my web designer/developer
I am buying my own darned hosting, for myself, thank you.
Other

Company Name
Your title
Email address NOT hosted by us
Postal Address
Phone
Other phone
FAX

How would you prefer to pay?
Paypal (Your PayPal billing email:
Credit Card
Mailed check or money order
Other: What did you have in mind?

Is there a web consultant who should also get a copy of the set-up info?
Name
Email

How did you find us?
Someone referred me:
Search engine
Saw you on an email discussion list
Saw your advertisement
Other:

Anything else we need to know?
(Additional domains to be parked, an external email/MX setting, , help with moving site, assistance with setting up email accounts, etc.) DO NOT ENTER CREDIT CARD INFO ON THIS FORM.

Anything else YOU need to know?

 

 

 



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