Palmary Web Hosting Application Form
Please fill the application form below and make sure the information is valided. By submitting the application form, you agree our
Web Hosting Terms of Use Agreement
.
Personal Information
Contact Name
Telephone No.
Email Address
Service Information
Service Plan
Please select
Basic Hosting ($816)
Professional Hosting ($1656)
Basic Email ($360)
Professional Email ($780)
Valued-Added Service
Additional Storage (Each 10MB)
Qty:
Additional POP3 Email
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Additional MySQL DB
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Domain Type
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Register new domain by Palmary
Register new domain by customer
Transfer domain to our server by Palmary
Transfer domain to our server by customer
Domain Name
Additional Info
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