Web Hosting - Order Form

	WEB HOSTING OPTIONS Please select from the available plan options below
	CMI HOST 20 - 20Mb storage, 10 emails $145.00 /yr CMI HOST 100 - 100Mb storage, 20 emails $199.00 /yr CMI HOST 150 - 150Mb storage, 50 emails $299.00 /yr

 

	CUSTOMER DETAILS
	First Name Last Name Company Address   Town/Suburb State WA NSW QLD VIC ACT SA NT TAS Postcode Please ensure you enter the area code for any phone numbers supplied. Home Phone Fax Work Phone Mobile Email

	PAYMENT Please select from the available payment options below
	- from your cheque or savings account and payable to CM Internet Cheque/Money Order - payable to CM Internet and post to CM Internet Direct Deposit - deposit your cash, cheque or money order at any Bankwest branch Credit Card - a 2.2% surcharge will be charged for all credit card payments.

	TERMS & CONDITIONS
	I declare that I have read, understood and agree to abide by CM Internet's Terms & Conditions. Click here for a printable version of the terms & conditions. You must have Adobe Reader 6 installed. To update or install Adobe Reader click here.