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Thank you for choosing IT Wired for your hosting needs. Please fill out the below.
Once your account has been setup you will recieve a setup email to the address listed in the billing section.

Required FieldDenotes a Required field.

Billing Information
Company Required Field
First Name Required Field
Last Name Required Field
Billing Address Required Field
Address Con't
City Required Field
State Required Field
Zip Code Required Field
Telephone 1---Required Field
Fax 1---Required Field
Email Address Required Field
Confirm Email Required Field

Domain Name Information
Hosting Package Required Field
Domain Name Required Field
Dedicated IP
Please specify a user name and password for the account (must be at least 6 characters long).
This will be the login for your account and will be referenced for all support issues.
All user names and passwords are case sensitive.
User Name (case sensitive) Required Field
Password (case sensitive) Required Field
Verify password Required Field

Technical Contact Information (i.e. Site Developer)
Technical Contact
Phone 1---
List additional authorized contacts

Additional Comments

  Terms and Coditions

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YES, I have read and accept the terms above.