Service Account Application

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Complete the form below to establish your On Equal Grounds; website hosting, website management, website design, publicity management, or project management account. 
After submitting the form then you may proceed to order the services desired. Be sure to use same names and email addresses here and for service orders. This is a verification for security and service. You will be contacted as soon as we receive your account application with your account details. The purchase of any On Equal Grounds service comes with a free On Equal Grounds Network membership and benefits. 

As an added security measure it is necessary to place  your email address 
           here:* 
           and in the form below. The email address given must be the same and valid. 
           * Indicates a required field.

First Name*

Last Name*

Title

Organization*
(if applying as a business or organization)

Street Address*

Address (cont.)

City*

State/Province*

Zip/Postal Code*

Country*

Work Phone 
One phone contact point is required.

Home Phone

FAX

E-mail*

URL

          Please provide your account information: 
           This will not be the same user name and password you wish to use to access the services such as website hosting. User names and passwords may be up to sixteen spaces long. 

User Name*

Password*

Confirm Password*

          Which On Equal Grounds services are you planning to utilize?

Which On Equal Grounds services are you planning to utilize?


How did you hear about On Equal Grounds?

* By checking here, submitting and applying for service I place my signature stating that I have read and agree to the Terms of Service and that I wish to request service. Use of service also constitutes a statement of acceptance of use by the customer.

On Equal Grounds 2017