Application - Web Hosting

Web Hosting Application: Please complete the following form then click submit. * indicates a required field.

Full Name: * Billing Address: *
Current Email Address:

Phone Number:

*
Mobile Number:

Fax Number:

Package Required:

ADSL and Dial-Up Service:

New Domain Name
If required: www.

Email Virus Protection:

 This service is now included
 in all Solution packages.
List alternatives in case yours is already taken.
 
FrontPage Server Extensions @ £26 + VAT per annum:  
Other Domains
If required:
Please list all
£10+VAT per annum
per domain (includes
redirect to your
main site)
Matrix Statistics installed on web site @ £15 + VAT per annum:  

 Note: Included with Business Solution
 package
Domains to be transferred:
£10+VAT per annum
parking fee


I agree with the Terms
and Conditions.
Note: No application will
be processed unless
you check the box.
 I agree:

 View Terms and Condtions
Username for Dial-Up Account:
Reset form

Click to send application form
Longcrest Systems Ltd, Park Lane House, 7 Park Lane, Sutton Benger, Chippenham, Wiltshire, SN15 4RN, United Kingdom
 
I Home I Customers I Examples I Contacts I ICT I Products I Services I Support I Web-Services I Terms and Conditions I Privacy I © 1998-2006 I
Tel/Fax: +44 (0) 1249 720755 /894
Consumer Credit License No. 523692