InterNic Domain Registrations

Organization (Registration) Information

Your E-mail Address (important, double check)
Last name, First name:
Legal owner if different then above?
Organization Address:
City, State:
Zip/Postal code:
Two letter Country Code: Sample: US
Phone number:
Fax number (optional):

Domain Names Requested

Do not enter "http://www.", Do not enter spaces, periods or underscores. There is a 67 character maximum including the 4 characters used to identify the top-level domain such as .COM, .NET, and .ORG, .May contain letters, digits, and a dash ("-"). Cannot begin or end with a dash.

Enter (good example):	yourdomainname.com	is correct.
Enter (good example):	your-domainname.com	is correct.
(Bad example):	your.domainname.com	is not correct. (no periods allowed)
(Bad example):	your_domainname.com	is not correct. (no underscore allowed)

Domain Name Requested for Registration:

Please include .com, org or .net (example; yourdomainname.com)

Domain registration and web hosting
and/or email and website forwarding options:

Our one time registration fee is $29.95 and $70.00 for 2 years

Of Internic registration for each domain.

E-mail forwarding:	Optional email forwarding is $5..95 per month (payable quarterly)
Website forwarding:	Optional website forwarding is $5.95 per month (payable quarterly)
Webhosting:	Optional hosting is $17.85 (1st 3 months special!) after that $5.95 per month (payable quarterly)

Please indicate your choice

If you have chosen a hosting package, will you be using Microsoft FrontPage?

Additional names: (add as many as you like at $29.95 and $70.00 Internic fee per name)

1 name per line
name1.com
name2.net
name3.org
name4.com

Billing information Information

Card name:
Card number (Type without spaces):
Exp. Date, Month/Year (sample 11/02):
Exact name as on card:
Billing Address of this credit card:
Billing City, State:
Billing Zip/Postal code:
Billing Country:

Billing and Registration Agreement

I agree to pay a one time fee of US$29.95 and $70.00 Internic fee to Internet Advisors for a total cost of US$99.95 for each domain name processed for registration. I agree to pay additional fees if I have chosen one of the optional hosting or email packages. These will be the ONLY amounts charged by Internet Advisors to the credit card I have chosen above. Internet Advisors will register my domain names (as indicated above) according to the instructions I have entered . I will NOT be charged for any name NOT available at processing. I understand that the $29.95 and $70.00 is non-refundable after my domain name has been registered. It will show on your credit card statement as from Internet Advisors.


Please us this for comments or concerns;

Search Your Domain Names below:

The maximum length of "domain name" is 63 characters preceding the .com( .net, .org)

www domain- registrations � 2000