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Refund Form   Personal Information Fields that are marked with a red * are required. * Name: * Email: * Phone: (i.e. 333-555-1212) * Street Address: * City:   * State:   * Zip: * Country: Host Information * Host: -- Select A Host -- HostICan LunarPages WebHostingPad BlueHost HostMonster * Package: Account Information * Domain: * Date of Signup: Payment Information * PayPal Email: We need this to send your rebate.     Free Hosting Refund Terms & Conditions In order to qualify for your Free Hosting Refund, the participating web host must activate your account and confirm that it is valid. If for any reason your new web host invalidates your order, we are not able to provide a Free Hosting Refund.

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