EziHosting Resellers Order Form

Congratulations!!!

On your decision to become a EziHosting Reseller.
Your Domain:
Contact E-mail:
Client Domain:
Hosting Plans
Yearly Client Plans
Amount
Months
100 Mb (Per Year) $85.45 / year
Months
150 Mb (Per Year) $131.59 / year
Months
500 Mb (Per Year) $247.47 / year
Months
1000 Mb (Per Year) $329.99 / year
Once off
Application Fee $100 / Once Off

Once you paid your once off set-up fee you receive your own 100 Mb hosting package free for live as long as you have at least 1 of your clients on our servers,

If this is you original application you need to fill out all the fields below.
If you ordering additional hosting packages for your clients, then there is no need to fill your personal details again.
(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 Authorization:

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, 2041 Channel Highway Electrona Tasmania 7054

Credit Card Fraud will be prosecuted!
Your details have been logged!
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