March 11, 2010
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This form is for our new customers who needs help
pointing there domain to Eugene Hosting's servers.

PLEASE ENTER YOUR DOMAIN'S REGISTER LOG-IN INFO ONLY
NOT YOUR WEB HOSTING ACCOUNTS LOG-IN INFO.

* Denotes required field

Please provide the following contact information

 

* Your Domain Name:

 

* First Name:

 

* Last Name:

 

* Email Address:

 

* Log-in URL Address
( NOT: mydomain.com ):

 

* UserName/UserID:

 

* Password:






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