Web Hosting Worksheet All required fields are indicated with a red askterisk (*). Contact Information Name * First Last * Last Company / Organization * Email * Domain Name Will we be registering a new domain name for you? * Yes No List your top 10 desired domain names, in descending order of preference * NOTE: Please separate each domain name with a comma and put your number one choice first, your second choice second, etc. We ask for a list of ten because it's extremely rare that your first choices are not already registered. Which company is your domain name registered through? * 1and1BluehosteNomGoDaddyHostGatorNetwork SolutionsRegister.comOther Please specify * What is the username/login on your account? * What is the password on your account? * Email Setup Which email hosting provider will you be using? * Zoho Mail G Suite by Google Cloud Office 365 Exchange Server (self-hosted) Other Please provide contact information (name, email address & phone #) for the person who manages your Exchange Server * Please specify * Do you want our help getting your email set up? * Yes No Please enter all of the email addresses you would like to have set up at your domain (i.e. [email protected]) * NOTE: Please separate each email address with a comma. Comments / Additional Information reCAPTCHA