WP Service Form - International Group of Anthony

Order ID (required)

Contact Infomation

Your Name (required)

Your Email (required)

Address Line 1

Address Line 2

City

State / Region / Province

Country

Domain Name [ .com / .org / .net / .info ] can be purchased here or added later on.

Website / Store Name (required)

What would you like your website / store to look like?

Anything you want to include on the website / store? [eg. Phone Number, Address, Logo]

Web Content

Policies [eg. Refund, Terms of Service, Privacy]

Products [If Applicable]

Other

IGA Hosting Username (If Using IGA Hosting)

Database Name (If NOT Using IGA Hosting)

Database Username (If NOT Using IGA Hosting)

Database Password (If NOT Using IGA Hosting)

Database Host (If NOT Using IGA Hosting)