Step 1: Tell us about yourself
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| Name * |
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| Company |
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| Address 1: * |
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| Address 2: |
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| City: * |
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| State/Province: * |
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| Zip Code: * |
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| Country: * |
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| Email * |
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| Phone * |
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| Location: * |
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Step 2: Tell us about your list
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| Administrator's name * |
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| Administrator's email * |
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| Administrator's password * |
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| ListHosting Packages & Options |
| Package * |
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| Custom Domain |
* Please indicate your Custom Domain in the field below. Custom
Domains are included with the packages marked with " * " above.
If you want to use your organization's domain (e.g., @mydomain.com), you must include a "preface" in front of it, for example: newsletter, lists or some other brief term that
relates to your list. Your Custom Domain would therefore look something like: @newsletter.mydomain.com.
Please DO NOT simply use your organization's standard domain. If you need help, contact us with your questions.
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| Options |
Extra list for Basic pkg
($100/mo + $50 set-up*)
Custom domain for Basic pkg
($100/mo + $50 set-up*)
Add-on list for any Newsletter pkg
($100/mo + $50 set-up*)
Extra custom domain for any pkg
($100/mo + $50 set-up*)
Getting Started package
($150 for introductory training)
* When you select any of the options above with this order, we will waive the standard set-up fee of $50. We will apply this fee, however, if you add an option at a later date with the service addendum.
If you select an option here, please make sure to indicate the list or domain name, admin info, etc. at the bottom of this form. |
| List Configuration |
| List name * |
In the field below, please enter the name of your list (e.g., dailynews, sales-specials, etc.). Your list name should be descriptive, and we suggest that you think about it in the context of any Custom Domains that you have selected, above.
IMPORTANT NOTE: The name you select will appear on all messages that list members receive, including the subscription form. If you prefer to use several, separate words, you must use a hyphen (-) or underscore (_) between words (e.g., music-talk).
Please select your list name carefully — once configured, it cannot be changed! We also recommend that you limit it to fewer than 15 characters, to prevent references to your list from word-wrapping in email readers.
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| List purpose * |
Please describe briefly the purpose of your email list.
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| Members * |
What is the approximate number of current list members?
Is your list membership permanent, or does it change each time?
Permanent (i.e., list members are added or deleted as needed)
Changes (i.e., a different list for each mailing) |
| Activity * |
How often are you planning to send messages out? (This helps us with resource planning.)
Daily
Once a week
Twice a month
Once a month
If daily, how many messages you expect to send each day?
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Step 3: Method of payment
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| Choose one * |
Credit Card via this form - read more
Credit Card via fax - read more
Credit Card via phone - read more
Purchase Order (select packages only - read more)
IMPORTANT NOTE: Your card will not be charged until you have been contacted by your Lyris account representative to complete the set up of your ListHosting account. |
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| Credit card type: |
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| Credit card number: |
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| Expiration date: |
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| CVV security code:
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The CVV security code usually can be found on the back of your credit card. It is a 3-4 digit number printed at the top of the signature strip. American Express has a 4 digit number on the front of the card.
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| Name on card: |
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| Card holder's billing address: |
Same as mailing address above
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| Address 1: |
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| Address 2: |
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| City: |
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| State/Province: |
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| Zip Code: |
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| Country: |
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| Phone & Ext.: |
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By completing this Order Form and clicking "Submit" below, you indicate your agreement to the terms and conditions of the Lyris ListHosting Service Agreement, which terms and conditions are incorporated into your order by this reference.
Please also note that Lyris reserves the right to decline to accept any ListHosting application for any reason at our sole discretion. |
