Site Solutions 4 U - The New Standard In Value Web Design & Hosting

On-Line Web Order Form

Thank you for choosing Site Solutions 4 U. Please fill out this form completely. Once your order has been received, we will contact you to verify that we have received your information. At that time, we will gather some additional information about your website needs, and will submit 3 website designs within 5 business days for you to choose from.

Once all design work is complete, your domain will be set-up on our servers in approximately 24-48 hours and account access information will be e-mailed to you upon completion.

Please read these Terms & Conditions before continuing. If your browser doesn't support the form below, please call (630) 961-6135 and we can fax you a copy.

Thank you very much for your business. (*denotes required field)

Account Sign-Up
Registration Type*	New Domain Transfer Existing Domain
Domain Name	www. Check Domain Availability
Plan Type*

Account Holder Information
First Name*
Last Name*
Company Name*
E-Mail Address*
Address*
City*
State/Province*
Zip / Postal Code*
Phone*
Fax
Comments Or Special Instructions
How Did You Find Out About Us or Who Referred You?	(optional)

Payment Information
(Transactions Kept Confidential Through Our Secure Server) We accept Visa, MasterCard and American Express.
Card Number
Name on Card
Expiration Date
Please Call Me	(If you would prefer to provide your card number over the phone.)
Card Billing Address (if different than above)
By completing this form, I confirm that I understand the rates and set-up fees related to the account and I agree to abide by the terms and conditions. (You must check here to proceed.)