P.O. Box 702 Midway, UT 84049 Toll Free: (866) 566-HOST |
(A PDF version of this form can be found by clicking here.)Bandwidth Authorization FormDear Valued Customer, Please provide the following information for billing purposes. Please note that your account will
not be allowed over the |
When completed,Please fax this form to 801-226-9052ORScan and email this form to billing@prohosting.com |
ACCOUNT INFORMATIONYour account number can be found in your Account Control Panel. It is necessary that you call our billing department for pre- Domain Name: ________________________ |
BANDWIDTH INCLUDED
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CARDHOLDER INFORMATIONFull Name: __________________________ CC Type: __AMEX __ Mastercard __VISA CC Number: _________________________ CC Expiration: __/__ |
AUTHORIZATIONI hereby authorize ProHosting, Inc. to use the credit card information on this form to process my recurring billing for bandwidth services. I understand that ProHosting, Inc. will disable my website when I have reached my bandwidth limit as stated above. Cardholder's signature: _____________________________ Date: _____________________ |