evolv - custom graphic design and web development for the small business

Domain Name & Web Hosting Sign Up Form

To purchase a domain name and/or web hosting package complete the following form. Even if you are not ready for a web site, it is wise to secure a good domain name as soon as possible due to competition. You can also set a target date for getting a web site developed when your budget and time permits. If target date is set, we will send you a reminder to see if you are ready at that point in time.

We will contact you for payment following receipt of this form. Please note that any domain names purchased will be put in Evolv's name until payment is made. At that time, the registrant info will be changed over to the proper owner.

Note: Fields marked with an * are required

Domain Name(s) to purchase:

(don't forget to include the extension)

Domain Name(s) that you already own:

Transfer Domain Name:

I authorize the transfer of my existing domain name for $8.95

Transfer Web Site Hosting:

I authorize the transfer of my existing web site hosting for FREE

Web Hosting Package:

Evolver Plan ($10/mo plus additional features)
Submission of this signup form or use of an Evolv host account indicates acceptance of the terms of this agreement by the account holder.

*Your Name:

Company Name:

Telephone:

*E-mail:

Contact Preference:

email telephone

Comments:

Web Site Development Target Date:

Use this field if you are not ready
for a web site currently but may be
in the future and therefore want to
set a target date so that we can
send you a reminder.