Building Blocks Sign Up - New Customer
After filling the details click on the SUBMIT button.
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indicates required fields
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Full Name:
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Mailing Address:
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City:
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State:
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Zip:
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Contact Phone Number:
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Contact email Address:
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Username - First Choice:
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Username - Second Choice:
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Password - (min. 8 alphanumeric characters):
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Date of birth for security purposes:
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Choose your Building Blocks Package:
Business Card $2.95 Monthly
Starter Site $4.95 Monthly
Personal/Business $8.95 Monthly
E-Commerce/Advanced Personal $12.95 Monthly
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Do you plan to use your own Domain name?:
Yes - $5.00 per month
No
What is a Domain Name and do I need one?:
Please visit Domain Hosting FAQ's at http://http://newsite.goldenwest.net/faqs
If yes, is the Domain name currently registered?:
Yes
No - Register your domain name at http://www.gkg.net/rbin/register/gwtc
If yes, what is your Domain name?:
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Billing Information:
Email (Cash or Check) $25.00 One time setup fee
Credit or Debit Card (No setup fee) We will call you for credit card info
Bank Withdrawal (No setup fee) We will call you for banking info
Invoicing (hard copy) $3.00 per bill processing fee (Cash or Check) $25.00 One time set up fee
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Preferred Communication Method:
Contact me via email once service is activated
Contact me via phone once service is activated
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Terms:
I agree to pay the fees outlined above.
I agree to the terms and conditions in the Member Service Agreement online at www.goldenwest.net.
After filling the details click on the SUBMIT button.
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