Copy and complete this form. 


This order form is to register a domain name.

.com  -  .net  -  .org   -- extensions cost $15/year.
 
.info  -  .biz   -- extensions cost $30/2-years.

.us -- extension costs $36/2-years

 
We only register .com, .net, .org, .info, .biz & .us domain extensions.


Domain Name Wanted Registered: __________________________________

Organization Name: ___________________________________

Your Name: _________________________________

Address: _____________________________________________________

Phone:  _______________________ Email:  ________________________

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If paying by credit card:

Credit Card#:  _________________________ Exp Date:  ________________

Cardholder Name:  ______________________ Card Zip:  ________________


Complete credit card info above or send a check to:

MinnesotaShopper.com
P.O. Box 703
Grand Rapids, MN  55744


All charges on your credit card will come from F.W. Hosting.