New Account Set-up Form

This sign-up form is for new customers only. If you currently hosting / reselling with Web Design Innovation, please contact us or your customer service/reseller account representative.

Web Design Innovation will process your new account order within 2-24 hours once your initial payment has been received. Once your account is setup you will be able to start uploading and accessing your control panel.  New Domain name registration or if you are transferring your domain, will take up to 72 hours before it will show on the internet.

Please read our policies before submitting this form.

         C o n t a c t   I n f o r m a t i o n

Name:

Company:

Domain Name:

Billing Address:

City:

State:

Zip Code:

Phone:

Fax:

Billing E-mail:

D o m a i n  N a m e  C o n t a c t  I n f o r m a t i o n
         This section is for new domains only.

Domain Name:

Owner Name:

Address 1:

Address 2:

City:

State:

Zip Code:

Country:

E-mail:

Phone Number:

Fax Number:

Years Registered:

Select One 1 Year 2 Year 3 Year 5 Year   Additional fees may apply.

D o m a i n  I n f o r m a t i o n
         This section is for transferred domains only.

Years Registered:

Select One 1 Year 2 Year 3 Year 5 Year Transfer Domain Only   Additional fees may apply.

Transferred Domain Only

User Name:

Password:

Registrar Name:

W e b  D e s i g n  I n n o v a t i o n  S e r v i c e s

Website Design:

Select Design Package Economy - $250.00 Bronze - $375.00 Silver - $450.00 Gold - $600.00 Platinum - $750.00 Email Promotion

Website Hosting:

Select Hosting Plan W.Host-A $14.95 mo. W.Host-B $24.95 mo. W.Host-C $34.95 mo. W.Host-D $44.95 mo. w/ service W.Host-E $69.95 mo. w/ service W.Host-F $99.95 mo. w/ service Email Promotion

Website Template Item #:

Note: All fees must be paid before your new account will be setup. Please contact your customer service/reseller account representative for rates. If you have not been working with a customer service/reseller account representative you will receive an email with online payment options or please mail your check / money order payable to:

Web Design Innovation
PO Box 940444
Miami, Florida 33194
Attn.: Billing Department

View Hosting Rates for initial payment.

Please Contact Us for web designing rates.