IMPACT Platinum

The IMPACT Platinum Web Site Solution Setup Form

* Name: * Email:
* Location * Website
* Phone Number * Address
* City / State / ZIP / /
Comments, Questions or Special Instructions:
 
 
1). Email Forwarding Setup:
Forwarding Website Email Forwards to
(ie. mary@yourimpactdomain.com) (ie. marysemail@yahoo.com)
2). Email Inbox Setup (Outlook):
Website Email Password
(ie. mary@yourimpactdomain.com) (ie. impact)
   

Please fill out the fields below. We will need this to transfer your nameservers or to repoint your domain name IP Address to our servers. This will ensure that your web site will appear when your domain is typed or entered by your customers.

Note that you will not need to sign up for a separate hosting account. Your $47/month recurring IMPACT Platinum Web Site payment covers both hosting as well as access to your Administration Tools.
Registrar:
Website where you purchased your domain name
- like GoDaddy or My Fitness Company
Account User ID#:
Account Password:

Sign up for a Merchant Account to receive credit cards via your online registrationvform. Make sure this box is checked in order to
sign up for a merchant account.
I already have a Merchant Account. Please contact me to obtain the Merchant Account details including API, company, username and password. NOTE: In order to process payments directly from your web site via a custom shopping cart, a $900 setup fee for API integration and shopping cart customization may apply.
I do not want a Merchant Account at this time (PayPal, Cash or Check Only).
   
How did you hear about us?
   
Click here to read Terms of Service.
* Required Fields
 

IMPACT Platinum