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Web Hosting Service Order Form

Plan I (25 GBs) - $6.95 Monthly


Contact Information

Your Name :
Your E-Mail Address:
Your Phone Number:

Domain Information

We can host all International and Internic registered domains. We will register any available .com, .org and .net domain for you as part of your service plan for onyl $9.95 for the first year. You can also select a domain name such as yourname.route66.net or yourname.web66.com.
Domain Name :
Registration :

Account Information

Select Plan I below. If additional space is needed you can upgrade to Plan II (50 GBs) for $9.95/month. All accounts have reseller privileges where you will get discounts on additional servers. Please also select from our Standard Hosting (CPanel, PHP/MySQL, Fantastico) or Microsoft Windows Server (Plesk and ASP.NET).
Account Type :
System Type :

Please select a login name of 3-8 characters. Use only a-z and 0-9, and the first character must be alphabetic. We will do our best to accomodate your request.
Username :
(second choice) :

Please select a password of 6-8 characters. Use only a-z, A-Z and 0-9.
Password :

Organization and Billing Contact

Please enter the information for the person who will be responsible for future invoices and billing. If you are paying by credit card, this information must match the credit card billing information.
Contact Name (First Last):
Organization Name:
Street Address:
Postal Code:
Phone Number:

Payment Information

NSSB will charge your credit card for the first three months service. If you are paying by check, please submit payment to NSSB, PO Box 9203, San Bernardino, CA 92427. We often verify that an order is legitimate before it is processed, so please make sure the above information is correct.

If you are paying by credit card and you do not wish to submit your information here, you may call us at 1-800-622-2055.

For further information call 1-800-622-2055 or E-Mail NSSB.

Name on card :
Card Number :
Expiration : Month : Year :
Security Code :

Processing this form may take a few minutes. Please be patient. It is not necessary to re-submit your request once the server is contacted.

Please send comments or corrections on these pages to webmaster@web66.com

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