domain order form      
 
  Pay offline Domain Orders  
*This Domain Order Form is for those who do not want to pay online for their Domain and/or hosting - Please Fill in your details below with your Searched Domain Name ( search again ) and submit below. If you want to Register a Domain Name immediately - please go back to the Home page - Search for the Domain and pay online with your Credit Card

NB: *A Invoice will be sent for payment before the Domain Name can be registered.
 
       
 
Business Name:
Contact Name:
E-mail Address:
Phone Number :
Type of Business:
Address:
City:
State:
Post Code:
Country:
Register Your Domain Name Type any domain and domain extension found
on our server


Type in your Chosen Domain(s) Name
with chosen Domain Extension
for Registration



1
eg yourdomain.co
m.au

and/or
2
eg yourdomain.com
and/or
3
eg yourdomain.net
or any other domain extension
in our domain price list

Found with the WHOis
Search Engine on this Home Page



If ordering a .com.au/.net.au Domain Extension

You must be a registered Business in Australia

Please Provide your ABN/ACN Number for verification- (read Terms and Conditions )


ABN/ACN
Web Hosting (if required )
Choose a plan below - (more information here )
 

50 MB $156/yr 75 MB $180/yr

100 MB $200/yr 150 MB $225/yr

200 MB $250/yr 500 MB $275/yr

700 MB $324/yr 1500 MB $360/yr

Payment Methods :

I will be paying by
Tick one

Direct Bank Deposit at my local bank
*we will e-mail you Banking Details

*requires 48 hours clearance
1


Internet Banking Online
*we will e-mail you Banking Details

*requires 24 hours clearance

2


Posting a ***Cheque

*Requires 1 week clearance after it is deposited

3
Domain Name has been paid

* I am registering it in my name only


4





***Please make cheque out to

Arakhne Web Design

and sent it to

Joanne Smith
PO Box 193
Wundowie WA 6560

with a copy of this application

** printed from the web page that appears after you click submit this form

Thank You

Service Agreement - Registrant's obligations: Please Read before sending this Form




Thank You for filling this Registration Form
We will contact you shortly with a Invoice for Payment Offline with our Banking Details

We accept:

  • Direct Bank Deposit - 3 working days clearance
  • Banking Online - 24 hours clearance - recommended - faster service
  • Cheque's. - 5 working days clearance not including postage time
  • *By sending in this 'Domain Order Form' does not STOP your chosen domain(s) being registered by other users. It is only when payment is received from the Invoice issued to you (after this Form is received by ADN ) will the Domain Name be then forwarded for approval.

    Your Domain Name will be purchased when all funds are cleared in our account. Please note, the faster the funds are received the faster your Domain Name is Registered...don't miss out!

  • IMPORTANT NOTICE:

    IMPORTANT NOTICE:  By submitting this application for a domain name, you confirm that you are eligible to hold the domain name set out in this application, and that all information provided in this application is true, complete and correct, and is not misleading in any way.  If any of the information is later found not to be true, or is incomplete, incorrect, or misleading in any way, or if you have submitted this application in bad faith, the domain name licence can be cancelled and you can permanently lose the use of the domain name.

     
                   
We also Sell |.com.au |.asn.au | .id.au | .net.au | .org.au | .net.nz | .co.nz | .com | .net | .biz | .org | .info | uk.com | .co.uk | .us.com | plus 500+ domain- ask!

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