ORDER

To order your account, please fill in the whole of this form. If you have any questions, please contact our sales team.

Do not use this form for reseller orders - click here instead.

Service Information

Web Service	Gold US$35.00 X 3 + US$0 Setup = US$ 105 Silver US$12.00 X 3 + US$0 = US$ 36
Additional Disk	5Mb additional disk space - USD$ 2 x 3 Months = US$ 6 10Mb additional disk space - USD$ 4 x 3 Months = US$ 12 15Mb additional disk space - USD$ 6 x 3 Months = US$ 18 None
Payment Options
Cash		Anyone can use this option. You can send cash (US$ or Euros) by mail  to our office, for the amount stated above.
SWIFT Payment		Anyone can use this method. We will e-mail you our bank details so you can forward payment.
Personal Information
Contact Name:
Company Name:
Address Street, City, State and Postal Code:
Country
Daytime Telephone:
E-mail address:
		you must quote a valid e-mail address
Refer ID:
		If someone referred you to our service then enter their customer ID here
Service Information
I would like to be hosted on your:	Washington DC Servers London, UK Servers
	Please install FrontPage Extensions on my account
		only check this box if you intend to use the extensions
Desired domain name:
		this box will be ignored if you are ordering a Silver account
Desired login name:
		You must choose a unique login name, therefore names like “webmaster”, “root”, “sales” etc are not permitted. (Silver customers will have a URL of http://www.jcle.net/yourlogin/) Login name has no great significance for Gold customers.
Password:
Password: (to confirm)
Any other information/comments:
Click submit to send your order to us. You will then be returned to our sales pages. Thank you for choosing jcle for your web hosting requirements.			Yes No I agree with this terms and conditions

© 1991-2007 JCLE, Lda. All Rights Reserved.