RESELLER WEB HOSTING ORDER

Use this form if you plan to order and pay by Credit Card, cheque, money order or direct deposit.

Order type:

1

  WEB HOSTING DETAILS
   

Select Web Hosting Plan
* Yearly Plans = 2 months worth discount!

[View Plan Types]


*

 
 
   
       
  Primary Domain Name:
FREE Registration (.com/.net only)
Please choose a domain to be used as your nameserver. eg. www.yournameserver.com
       
 

 

 

  

Please Choose

  
 } Username and password must be comparably different. Alphanumeric only.  
Username (MUST be 4 to 14 characters)  
  Password  (MUST be 5 to 14 characters) 
       
  How did you find us?  
  More Specifically
       

2

  YOUR DETAILS
       
  Business Name (if applicable)
  Name
  Street / P.O. Box
  City / Suburb
  State
  Country
  Post Code / Zip
  E-Mail (must be valid)
  Telephone (include Area code)
  Promotional Code (if applicable)
       
  Have you read, understood and agree to abide
by the terms and conditions?		 Tick This Box
       

3

  PAYMENT METHOD
  Your Intended Payment Method 
  Auto-Charge
NOTE: For Credit Card holders only.
By ticking this box, you agree for your card to be charged automatically upon web hosting renewal.
Further details in Terms & Conditions.
       
 

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