Webhosting Contract

PRE-PAID CONTRACT FOR WEBHOSTING

Important:

This form is not for new customer use. It can only be used to pre-pay an existing phpwebhosting.com account.

If your account is currently past due, please add the appropriate past due amount to your payment. Your balance can be found under the billing section of your control panel.

If your account is currently past due and your site has been disabled, please let us know you are sending payment and we will re-enable your site as a courtesy while we wait on your check. You can send us a message via the help desk section of your control panel.

Instructions:

Please fill this form out on your computer, then print. If you decide to complete the form manually, please write
carefully - if we cannot read your contract, we cannot process it!

The following agreement is made between:

(customer name)

and

phpwebhosting.com, LLC
8888 Keystone Crossing Plaza
Suite 1300
Indianapolis, IN 46240
USA

___ Enclosed is $59.70 U.S. Dollars payment for 6 months of webhosting.
___ Enclosed is $107.76 U.S. Dollars payment for 12 months of webhosting.
___ Enclosed is $191.28 U.S. Dollars payment for 24 months of webhosting.
___ Enclosed is $ U.S. Dollars for past due balance

I understand that my payment will take effect upon my next monthly
payment date and will replace any current credit card billing arrangement.

Please apply my payment to my account named:

Your phpwebhosting.com username (not your domain name)

I understand that this contract cannot be cancelled and that refunds are only
made during the first 30 days of hosting.

I understand that this contract expires at the end of the term selected above and that
the contract will not automatically renew.

Signed:

___________________________________________
(printed name)

___________________________________________
(signature)

___________________
(Date)

(Contact Email Address)

Print this form out and send the completed form along with full payment of
in U.S. Dollars to:

phpwebhosting.com
8888 Keystone Crossing Plaza
Suite 1300
Indianapolis, IN 46240

Payment can be made by Check or Money Order. No cash please.

Please allow 7-14 days for checks to be processed.