EziHosting Resellers Order Form

Congratulations!!!

On your decision to become a EziHosting Reseller.
Starter Plan
Mid Plan
Super Plan
Set-up:
$50
$50
$50
Price:
$100/month
$250/month
$450/month
Domains:
20
30
100
Storage:
2 x 1000 Mb
2 X 2.5 GB
2 X 5 GB
Bandwidth:
1 X 15 GB
1 X 30 GB
1 X 50 GB
Control Panels:
20
30
100
Order:
Your Domain:
Contact E-mail:
If this is you original application you need to fill out all the fields below.
(Business) Name:
Contact Person:
Street Address 1:
Street Address 2:
City or town:
State or Territory:
Post Code:
Country:
Phone Number:
Fax Number:
Comments:
How did you find us?
What Search Engine?
Credit Card Authorisation*:
* Private Plan Resellers are charged automatically every month the account falls due until the plan is cancelled.

After you click on the "Confirm Order" button, you will be taken to a SSL Secure Payment Page where you can finalise your order.

 

If you do not want to use your credit card or you don't have one, then just print this completed form and post it with your cheque or money order to:
EziHosting Pty Ltd, 1287 Channel Highway Kingston Tasmania 7050

Credit Card Fraud will be prosecuted!
Your details have been logged!
Referred From:
Your Host:
Your System:
Redirect Status:
Your IP: