STEP THREE: ORDER FORM 

PLEASE COMPLETE THIS FORM 
AND SEND THIS INFORMATION TO US NOW  
so we can reply with the information you need.
(use the submit button) 

YOUR NAME (First and Last name)

 

YOUR MAILING ADDRESS, CITY AND STATE

 

YOUR CURRENT EMAIL ADDRESS  
WHERE YOU CAN BE CONTACTED

 

YOUR HOME PHONE NUMBER 
WHERE YOU CAN BE CONTACTED (include area code)

 

THE LOCAL DIAL UP NUMBER YOU SELECTED at Step 1

  • Include (Area Code) plus the "local" number
  • City and State 
  • and Provider

Forgot to write this information down?
Click here to link back to home page where you can find this important  infomation again and then return using the back button to complete form

 

A PASSWORD YOU WISH TO USE  
(small case letters please from 3 - 8 letters or numbers or mixed)

 

YOUR PREFERRED EMAIL NAME (small case letters please)
(example: username@mydoghouse.com)

 

YOUR SECOND CHOICE FOR AN EMAIL NAME (small case letters please)

 

PAYMENT CHOICE

I WILL BE PAYING BY CHECK OR MONEY ORDER 

I WILL BE PAYING ELECTRONICALLY USING PAYPAL (STEP 4) 

HOW DID YOU FIND MYDOGHOUSE? (optional)

A friend referred you to me
Learned about you thru the local Newspaper
Just browsing and found you

IF A FRIEND REFERRED YOU, PLEASE TELL US "WHO" 
SO WE CAN THANK THEM?

 

ADDITIONAL COMMENTS OR QUESTIONS

PLAN CHOSEN 

BIG DOG SPECIAL DIAL UP PLUS EMAIL AND WEB ACCELERATOR 

 
Be sure to click the SUBMIT button! 
  
Use the RESET button to erase all of the above and start over if you wish.

STEP FOUR: MAKE PAYMENT
EITHER QUARTERLY OR ANNUALLY
            

  • Pay quarterly $30.00