ChicagoGigs.com Hosting Account Order Form

Account Information

Artist Name:  ______________________________  

Domain Name (URL):  ________________________________
Do you want FrontPage extensions installed:  q Yes    q No
Do you want Log Files turned on:  
q Yes    q No
(note: Log files take up a lot of space.)

Select account type and billing interval: 

q Gold Package billed monthly
$17.95 per month + $20 set-up fee = $37.95

q Platinum Package billed monthly
$25.95 per month + $20 set-up fee = $45.95

q Gold Package billed quarterly
$17.95 per month * 3 months + $20 set-up fee = $73.85

q Platinum Package billed quarterly
$25.95 per month * 3 months + $20 set-up fee = $97.85

Your order will automatically renew in three-month intervals unless cancelled with 30 days notice. On your first renewal date, charges will be prorated to reset your billing date to the first of a month. After that, charges will be billed as selected as above.  (The set-up fee is only paid once.)

If order is placed with a credit card, all renewal charges will be automatically charged to your credit card. You may switch to payment by check by sending a request to contact@chicagogigs.com.

The full terms and conditions posted on our website at http://www.chicagogigs.com/notices/terms.htm
Our Privacy Policy is also available on our website at http://www.chicagogigs.com/notices/privacy.htm

Completion and submission of this Application constitutes Applicant's verification that he/she has read the  Terms and Conditions (Contract, Content Policy, Pricing and Payment Policy) available on the ChicagoGigs.com website and agrees to be bound by them.

 Payment Information
        q Payment by check or money order Please make payable to ChicagoGigs.com
        q Payment by credit card

For credit card payment:
Name on card: ________________________________________________________________________________

Billing address: _______________________________________________________________________________

City / State / Zip: ______________________________________________________________________________

Card number: ______________________________             Expiration date: _________________________________

Cardholder Signature: __________________________________________________________________________

Please fax to 847-381-8513 or 
mail to ChicagoGigs.com, Attn: New Accounts, P.O. Box 2419, Palatine, IL 60078-2419