Secure Order Form

 
Due to the increase in fraudulent orders from overseas, you MUST put a valid phone number on your order form, as we may call for verification.

Hosting Information 

The user name must start with an alpha character and can consist of alpha characters, numeric characters, the minus sign "-" or underline "_". Alpha characters must be in lower case. The length of User Name should be no more than 8 characters. For example, John Smith can have the user name 'jsmith123 - NOT 123jsmith'

Choose User Name: (8 character max.)  i.e  webduck2
Do not use a name that you want to later become an email address!
Choose Password:   (8 character max.)
Hosting Package:
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Domain Information

Domain Name:
http://www. (Please specify domain ending)

A domain which ends with .com, .net or .org will be registered automatically by us. Domain registration for other countries will be registered on our name servers, but the client is responsible for contacting the NIC in the respective country to complete the registration for other countries.

Do you already own this domain name?

Do you own your domain or want us to buy it for you?


Do to the change in how Domain Registries handle domains GH1 can no longer move the domains for you. We will help you move the domains if needed but you will need to provide us with the DOMAIN's user name and password!

If you own your domain already please set the DNS to the following settings:

Primary Name Server: ns1.gulfhost.com 
Primary IP Address: 23.238.34.73
Secondary Name Server: ns2.gulfhost.com
Secondary IP Address: 192.119.86.76

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Contact Information 
(Administrative Contact)
This must be filled out for hosting.

First Name
 
Last Name
 
Company
 
 
Street Address
 
City
 
State/Province
 
Zip Code
 
Country
 
 
 
Phone
 
Email
 
 
Fax Alternate E-Mail
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Billing Contact Information
Fill out ONLY If different from Administrative Contact

First Name
 
Last Name
 
Company
 
 
Street Address
 
City
 
State/Province
 
Zip Code
 
Country
 *
 
 
Phone
 
Email
 
 
Fax Alternate E-Mail
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Billing Information
This must be filled out for hosting.
The billing address you give Must be the billing address of the Credit Card!

We Verify Every Order By Phone!

           Card Type

Card Number
 
Expiration Date
 
Name on Card

e.g., - 4123-4567-8910-1234

e.g., 02/2004
 (CVV2)    Card Code  *Required
Card verification number (CVV2)
or Card Code.

It is a three or four-digit number that appears on the back of your credit card.
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Other Information

Comments:
 
How did you hear about us?

Promotion Code:
(if applicable)

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Anti-SPAM test

Please type human in the field below (this helps us block spammers):

Terms, Policies and Guidelines

By submitting this order, I have read and accept the terms and conditions outlined in the Terms, Policies and Guidelines of GH1.

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If you're having trouble using this form please email us at admin@noc4ua.com or call us at 850-393-0259. 

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