Domain Name Registration and Hosting Form.

Normal day it will only take an hour for your Registration application & Delegation to be processed.

The following prices apply for the more popular domain name registries & may change without notice:

Country	Domain	Application Fee (AU$)	Renewal Fee
Australia	.com.au	$39.99 for 2 years	$19.99 per year
New Zealand	.co.nz	$28.00 for 1 years	$28.00 per year
International	.com	$16.50 for 1 years $165.00 for 10 years	$16.50 per year
Biz domain extensions	.biz	$16.50 for 1 years $165.00 for 10 years	$16.50 per year
Australian domain extensions	.au.com	$16.50 for 1 years $165.00 for 10 years	$16.50 per year

Registrations: The registration of .com.au domain name, have quite specific rules of eligibility:

Unless a domain name is being applied for by a private individual, the registration application must be placed in the name of the business or company that is making the application.

You must fill in the required Red areas !

1st Domain Name:

www.

2nd Domain Name:

www.

3rd Domain Name:

www.

Registrant:

(Who will be the owner for the requested domain)

Title / Position:

Your Trading Name:

ACN or ABN:

(Company or Business Number)

State of Registration:

Policy Reason Description:

You need to explanation of why the Registrant is eligible for the requested name under the selected policy.

(eg. This domain name has close association to my/our business name or similar reason)

NIC Handle:

If you don't know what a NIC Handle is, then you won't need to fill this in.

Postal Address:

Town, City:

State:

Postcode:

Phone:

Fax:

Primary e-mail:

Other e-mails required:

Separated by comma (,)

Purchase Order Number:

If Applicable

Madog Media:

Hosting Package:

Bare Bones 12 month package. ($50.00) 250 MB Storage, 250 MB Bandwidth, 5 e-maill accounts.

Snow Gum 12 month package. ($75.00) 500 MB Storage, 500 MB Bandwidth, 10 email accounts.

Blue Gum 12 month package. ($100.00) 1 GB Storage, 1 GB Bandwidth Unlimited e-maill accounts.

Red Gum 12 month package. ($150.00) 2 GB Storage, 2 GB Bandwidth Unlimited e-maill accounts.

Additional Services:

Extra e-mail addresses.

Extra Mb of web space required.

Other Extras.

If other, please specify:

e-mail Configuration:

A default primary e-mail address needs to be set up,

usually something like, info@ or sales@yourdomain.com.au

What would you like Your's to be ? (seperate names by using a ",")

@yourdomain.com.au

Have the ABOVE email account(s) made with histing for Downloading.

Have all e-mail received at this address and Redirected

to my current e-mail address of:

Have you filled all the RED fields in above ?