Congratulations! & Thank you
 Print: Mail, Fax or Email Yourname.com order form Please complete this form, print, then Fax, to 361/668-0036 or Mail (with payment) to the address at the bottom of the page.
You can Email this form if you like, by pressing "Email" below. Thank you!

YourName.com displays your existing webpages regardless of its name. (e.g. http://www.trip.net/~username.html  to  only "yourname.com".  Also your email will have an unlimited address. (Joe@yourname.com, Wife@yourname.com etc.)

Customer Information

Your entry must match the name and address on your credit card, or your bank may decline the offer. All information is kept confidential unless you tell us otherwise. Your telephone or fax number helps us contact you for technical and billing questions.

Please feel free to write other information you think is necessary

FIRST NAME
MIDDLE
   LAST

STREET ADDRESS

CITY
STATE
ZIP CODE

Home phone (with area code)
Work phone (with area code))

Company name (if any)

YourName.com 1st choice

If not available 2nd choice

If not available 3td choice

Setup, one time charge $29

$15 per year. Enter as many years as you like


Total
Enter WWW address you want to display, or your
page number if you have one with us.

 Enter your existing email address where you want to recieve this mail.

Enter additional comments. Or if you only making changes to existing YourName.com's,
enter changes here. Changes $10 

Your Email Address

E-MAIL ADDRESS (one address only, no Web sites) i.e.,yourname@xyz.com(optional)

Payment Information

All of your payment information is kept strictly confidential.		   If paying by credit card, enter information below.
CARD TYPE: Visa Master Card Discover American Express
CARD NUMBER: CARD EXPIRES:

YOUR SIGNATURE:
_________________________________
Money Order: Make money orders PAYABLE TO TimcoUSA drawn from a U.S. bank or from an international bank with funds specified explicitly as U.S. dollars. Please send this completed form with your order.
Payable to TimcoUSA
Print & Mail or Fax
361/668-0036
427 So. Reynolds St.    Alice, Texas 78332
If you preferred you can Email this form here
this is a secure site. just press: Email.
This web page and web site has been developed and is maintained exclusively by RE Enterprises, DBA Eflash.com an Independent
Timco Representative. As Timco modifies its products, programs, and policies, information contained in this web site is subject to change.
This web site is authored ,sponsored and maintained by Timco. All rights reserve