WebHosting Reseller order form

This is our reseller program order form. We set up our resellers accounts manually to get you set up just the way you ask. We do have two completely different reseller plans, so make sure you understand wich plan your signing up for, then complete the form.
Welcome to superior-host.com , where being a reseller is an enjoyable experience.

Your Name:

Domain Name:

New domain Registration:
Transfering my domain:

Email Address:

Phone Number:

Company Name

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

POLICY:
Check here to indicate you have read and agree to abide by our policies and understand they may change without notice. Also, it is your responsibility to insure your customers also abide by our polocies.

Choose the Reseller Program You Prefer:

Please let us know how many sites you will be moving over to us within the next 30 days:

If reseller program 1, Choose the Hosting Plan for your main site:
Minimum size for your main account is 50 mb

If reseller program 2, Choose the Hosting Plan You Prefer:

Notes:

Credit card to use for monthly billing: If you choose to pay by Check, we will have you go to a form to enter your check details. We print checks electronicly, and deposit them on aproxamately the 3rd of each month.
We also accept paypal.

Name on card:

Card holder's Address (if different than above personal information):
If using PayPal, put PayPal email address for invoices here:

Card Number:
example: xxxxxxxxxxxxxxxx no spaces please.

Double check number please.
Expiration Date
(mm-yyyy):

By clicking on the submit button you have agreed to abide by the policies set in place for the good of our valued customers and our servers, and understand that if you break them your account can be deativated or deleted without notice!

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