This order will be submitted and encrypted on a PCI DSS Compliant certified secure server. Please see our Privacy Policy.
We do not set up any new account without prior receipt of payment. Visa / MasterCard / AMEX / Discover Credit Cards and PayPal accepted. We also accept checks. Send inquiry, if desired. If you already have an account with us and wish to submit new payment info, please use the payment form instead.
By filling out this order form and pressing submit, you authorize SITEWORKS to charge your credit card for the necessary amount to cover your web hosting services. For web hosting accounts, we will continue to charge your credit card for your monthly services, and this is done on the 30th day of the month to pay for the upcoming month in advance. If you have chosen a prepaid period as your option, you will instead be charged accordingly to your choice; either quarterly, semi-annually or annually. You may change a prepay at will. There are no contracts and you may cancel at any time. Although you may cancel your service at any time, you remain responsible for any monies due and payable at the time of cancellation. We will send you an e-mail receipt outlining any and all credit card charges.
* indicates required field Choose Account type: ---SPECIAL - 1,000 MBINDIE 1 - 3,000 MBINDIE 2 - 5,000 MB
Your Name (*)
Your Email (*)
Domain Name to be Used on Account (*)
Business Name, if applicable
Phone Number (*)
Choose credit/debit card type (*) Choose credit/debit cardVisaMastercardDiscoverAMEX
Name as it appears on Card (*)
Debit/Credit Card Number(*)
Expiration Date (*)
Security Code (3 or 4 digits)(*)
Billing Street Address (*)
Billing City (*)
Billing State (*)
Billing Zip Code (*)
Please acknowledge your understanding of these terms with a check here: I Agree **Charges appear on credit card statement as from SITEWORKS**
Added Notes:
I AM NOT A ROBOT:
