Hosting Set-up Request

Please fill in the sections below. It will take 24-48 hours to complete your request (assuming we have all the information, of course). You will receive a confirmation email from us notifying you when the work has been completed.

Hosting Set-up Request Form
Client/Designer Information
Name
Email
Company Name
Client Website Information / Billing Information
Full Domain Name
Company Name
Address
Phone
Fax
City,State, Zip
Custom FTP
Username
Password
Not needed; use existing account.
CGI-BIN
Included with your hosting package is our secure standard form mail. Click here for details. If you need to use your own cgi script, check yes, but please understand that a representative of Geek Internet Development, LLP. will be contacting you to discuss the security of your script.
Yes, please!
 No, thanks.
Email Forwarding
Complete this section if you are looking for us to create your requested e-mail address but have it forward to your personal e-mail address.
Email Address
 Forwards to
Email Address
 Forwards to
Email Address
 Forwards to
Email Address
 Forwards to
Email Address
 Forwards to
Email Users with Passwords (POP3 Accounts)
Complete this section if you are looking to have your e-mails reside on our servers and not forward to your personal e-mail address.
Email Address
First Name
 Last Name
Email Address
First Name
 Last Name
Email Address
First Name
 Last Name
Email Address
First Name
 Last Name
Email Address
First Name
 Last Name
Web Designer's Email Set-Up
This section is to let us know how you would like the webmaster@xxxxx.xxx set up.
Email Address
Forwards to
Domain Aliases
Also known as pointers.
Domain Alias Name
The email information above will be used unless otherwise noted.
If you need to set up additional email, use the box below.
Please list the email address first, followed by the email forwarding destination address or last name of the individual.
Acceptable Use
All hosting accounts MUST have a signed copy of our Acceptable Use Policy on file within 30 days of beginning service. Click below to download a form.
Acceptable Use: [pdf]
Additional Information
Is there anything else you want to tell us about this site?

Geek Internet Development, LLP
PO Box 61061 • Las Vegas, NV 89160
www.geekinternetdevelopment.com
Fax: (702) 436-9797 • Call: (702) 433-GEEK [4335]

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