Custom Domain E-mail Order Form
(Secure Order Form)

If you have any questions please call toll free 1.877.ESCAPE.NET -or- 1.800.985.HOST.
or 212-888-8780 (NYC residents) or e-mail info@escape.com.


Subscriber Information

  First Name
 
Last Name
Address (Line 1)
  Company or Organization Name
  
(if not applicable your name)
 
Address (Line 2)
  Phone
  --
City  
  Fax
  --
State/Prov.       ZIP
,
  E-mail Address
 
Country

Account Information
Domain Name
www.
Username  
Password (max. 16 characters)
Password Verification
Promotional Code
Payment Plan

The Monthly Plan is $6.95 per month
(+1 time set-up non-refundable fee of $10.00), a total of $83.40 for one year of service.  Our One Year Special is a pre-paid plan in which you receive a 20% discount (waived set-up fee).  Total of $66.72 for the year, only $5.56 per month.

 Additional Information


Where did you hear about Escape.net?


Method of Contact

E-mail     Telephone     Fax   

 

The cost to register a domain with InterNic (Network Solutions) is $70 for the first two years, and $35 for each year following. This payment will be billed to you, the subscriber separately by Network Solutions. By applying for the domain name and through the use or continued use of the domain name, the applicant agrees to be bound by the terms of InterNic's current domain name policy (the 'Policy Statement') which is available at: www.networksolutions.com/legal/agreement.html


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