Developed by
EACSI

Electronic and Computer Solutions

8120 E 12th Street, Unit A
Tulsa, OK 74112
(918)286-2816 Fax (918)834-9391
(a subsidiary of Electronic Assembly Corporation)

 


Web Hosting Service Order / Information Form

In order to reduce costs we do not offer online registration or credit card processing.
You will be contacted via email, phone, or mail to process your account.

Please Complete the following form or call (918)286-2816 to setup a new account.

Name:
Company Name:
Address:
City
State
Zip
Telephone:

eMail Address


if a email address is not available, you will be contacted by phone

Select Account
Select Account Options Static IP SSL mySQL Photo Gallery
Select OffSite Backup Options No Backup Daily Backup Weekly Backup
Select Additional Resources Additional Mail Boxes M Disk Space
Domain Registration Register New Domain ($15) Transfer Domain ($10)

Domain Name Requests / Transfers
Only One Domain Name will be assigned in the order of availability

1 2
3 4
5 6
Password Request: