If you do not have Internet or Web Hosting services with Golden West please use the "New Customer" sign up form.
Building Blocks Sign Up - Current Customer
*
indicates required fields
*
Full Name:
*
Mailing Address:
*
City:
*
State:
*
Zip:
*
Contact Phone Number:
*
Billing Phone Number:
*
Contact email Address:
*
Current Golden West Username:
*
Choose your Building Blocks Package:
Business Card $0.95 Monthly
Starter Site $1.95 Monthly
Personal/Business $3.95 Monthly
E-Commerce/Advanced Personal $7.95 Monthly
*
Do you plan to use your own Domain name?:
Yes - $5.00 per month
No
If yes, is the Domain name currently registered?:
Yes
No - Register your domain name at http://www.gkg.net/rbin/register/gwtc
If yes, what is your Domain name?:
*
Preferred Communication Method:
Contact me via email once service is activated
Contact me via phone once service is activated
*
Terms:
I agree to pay the fees outlined above.
I agree to the terms and conditions in the Member Service Agreement online at www.goldenwest.net.