Use this form to order your
Virtual Web Server and register or delegate your domain name.
If you need more information, then please E-mail our sales department or call us on 0412 050 477
| Business name | |||||||
| Address | |||||||
| ACN or Reg Business Number | |||||||
| Telephone | |||||||
| Fax | |||||||
| Domain Name | |||||||
| Is this domain already registered? | Yes No | ||||||
| Administrative Contact Person | |||||||
| E-mail Address | |||||||
| Telephone | |||||||
| Facsimile | |||||||
| E-Mail
Aliases and redirection details These aliases may be redirected to one single account or to six
separate ones. |
redirect to: redirect to: redirect to: redirect to: redirect to: redirect to: |
||||||
Additional information |
Server Type Personal WebSite Pack 1 month Payment Method MasterCard
|
|
!
|
!
Please make payment by cheque to:
Stiletto Software & Technology
PO Box 388, Williamstown 3016
For credit card payments by fax print this form and fax to 03 - 9397 0191
The Administrative Contact Person must be an employee or principal of your company. Please give the name of the managing director or the information technology manager or some similar figure. The com.au Domain Registry will use this if there is any need to get in touch with the owner of the domain.
If the domain name you are applying for is already registered but has never been used it must be delegated to us. There is a $au75 charge for this so please adjust the payment figures above to be a total of $au550. If the name is currently hosted by another ISP there is no charge for re-delegation.
