Bitter Merch
Hosting Information Request Form
For NEW clients who need any of our hosting packages.
Name
*
First
Last
Email
*
Company Name
Phone Number
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Which package are you considering?
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Standard ($10/month)
Silver ($20/month)
Gold ($30/month)
Solo Blog ($5/month)
Premium Custom (Starts at $20/month)
Unsure or More than one being considered
Please Describe (with some detail), the type of website you are looking to host. Do you need databases, PERL, PHP 4/5/6, etc. Also, if you have NO CLUE what you need - say it now.
*
When do you want to go live?
MM
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DD
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YYYY
Which will most likely be your method of payment?
Credit Cards/PayPal (Monthly)
Credit Cards/PayPal (Yearly)
Company Check (Monthly)
Company Check (Yearly)
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