Hosting Package Order Form (US Dollars)

To activate any one of our hosting packages simply fill in the following form, click submit and you will be given the option of choosing your package and then paying by credit card in US dollars (We also accept payment in Australian, Canadian, Euros and Pounds. If paying by check please print this page before submitting. 

All hosting accounts will be activated within 24 hours of the form submission and receipt of payment at which time a Welcome email will be sent with your User Name and Password. You will then be able to start uploading your site immediately.
For your convenience we accept Visa, MasterCard, Discover, American Express, Eurocard, Novus, and Debit cards. Cards from any country are accepted. We also accept checks and money orders. PayPal payment may be sent to paypal@surf22hosting.com.

Be sure to read our User Agreement before filling in this form. 

Full Name:
* required field
Company:
Address:
* required field
City:
* required field
State/
Province:
* required field
Zip/
Postal Code:
* required field
Country:
* required field
Phone:
* required field
Fax:
Email Address:
* required field
Domain Name:
* required field
Existing domain Please register for me**
User Name: (Maximum 8 characters)
The user name MUST start with alpha characters and consist of alpha characters, numeric characters, the minus sign '-' or underline '_' ONLY.
Comments:

I have Read And Agree to the Surf22Hosting.com User Agreement. 
* required field

Note: If you are signing up with us for the sole purpose of sending bulk email (Spam) or setting up a Phishing site all accounts are heavily monitored and we will shut you down immediately as this is a breach of the above User agreement. We are a hosting company, not a Spam conduit.



All information is kept confidential and is used for internal purposes only as per our Privacy Statement.

** If you pre-pay 12 months the domain name is free. Otherwise if paying monthly or every 6 months we send you the link to register your domain at the discount rate.