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	<HEAD>
		<TITLE>Create a free hosting account</TITLE>
	</HEAD>
	<BODY LINK="lightgrey" ALINK="lightgrey" VLINK="lightgrey">
		<*FORMSTART*>
			<CENTER>
				<H2><FONT FACE='verdana'>Create a free hosting account:</FONT></H2><BR>
				<TABLE>
					<TR>
						<TD><FONT FACE='verdana'><B>Subdomain/Domain:</B><BR>
						<I>No spaces or special characters and no www.</I></FONT></TD>
						<TD><*DOMAINFIELD*><BR>&nbsp;</TD>
					</TR>
					<TR>
						<TD><FONT FACE='verdana'><B>Username:</B><BR>
						<I>Your preferred cPanel username</I></FONT></TD>
						<TD><*USERNAMEFIELD*><BR>&nbsp;</TD>
					</TR>
					<TR>
						<TD><FONT FACE='verdana'><B>Email:</B><BR>
						<I>Your email address</I></FONT></TD>
						<TD><*EMAILFIELD*><BR>&nbsp;</TD>
					</TR>
<*SIGNUPKEYFILE*>
<*IMAGEFILE*>
				</TABLE>
				<FONT FACE='verdana'>
					<*SUBMITBUTTON*><BR>
				</FONT>
				<*COPYRIGHT*>
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		<*FORMEND*>
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