New Hosting Client Intake Form

Name*

First Last

Company Name*

Email*

Phone*

Website*

Average # of Website Visitors Per Month*

Services Requested:*

Do you know Type of Hosting Required?

Ex. Wordpress, Magento, VPS, Cpanel, Linux, Windows Plesk, etc.

List of Email Addresses to be Setup

**If more than 2 or 3, type "TOO MANY TO LIST" and request the lead/client email them all to Leo directly once Leo reaches out to the client.

Other Service(s) Requested:

How much are you currently paying/month?*

Timeframe To Get Started*

Primary Reason(s) for Switching?*

Any Special Requirements/Notes?*

Do you have more than 1 domain or website that needs to be migrated?*

List of Domains & Websites to be Migrated

**If more than 2 or 3, type "TOO MANY TO LIST" and request the lead/client email them all to Leo directly once Leo reaches out to the client.

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(612) 474-4550