Domain Hosting Form.

You must fill in the required Red areas !

Domain Name:

NIC Handle:

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

Contact Person:

Title / Position:

Your Trading Name:

Postal Address:

Town, City:

State:

Postcode:

Phone:

Fax:

Primary e-mail:

Secondary e-mails:

Separated by comma (,)

Purchase Order Number:

If Applicable

2yrs Bare Bones Hosting Only. ($70.00)

2yrs Snow Gum Hosting Only. ($90.00)

2yrs Blue Gum Hosting Only. ($140.00)

2yrs Red Gum Hosting Only. ($220.00)

2yrs Bare Bones Domain Registration & Hosting Deal. ($100.00)

2yrs Snow Gum Domain Registration & Hosting Deal. ($120.00)

2yrs Blue Gum Domain Registration & Hosting Deal. ($170.00)

2yrs Red Gum Domain Registration & Hosting Deal. ($250.00)

Extras:

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 yours to be ?

@yourdomain.com.au

Have e-mail held for collection at the ABOVE address.

Have all e-mail received at this address and Redirected

to my current e-mail address of:

Comments or Questions: