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HOSTING
DETAILS
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| Do you require domain name
registration: |
Yes
No
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Domain Name : |
* |
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Hosting Plan: |
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Would you like us to submit your site to leading search
engines like Google and Yahoo: |
Yes
No |
| Search
Engine Submission: |
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| Do
you require Front Page extensions: |
Yes No |
| Do
you require MySQL Database: |
Yes No |
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Do you require Shopping cart: |
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| Secret Word
in case you forget your hosting password: |
* |
| Your Preferred
Password: |
* |
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Invoice Email
Address: |
* |
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(Must be
current) |
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YOUR
CUSTOMER DETAILS
ONLY REQUIRED IF WE ARE REGISTERING A DOMAIN
NAME FOR YOU |
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Domain Name Required : |
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Name
of the Registered Company / Business: |
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Registrant Name: |
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(The person that will own this name,
not the company name) |
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For more information about the ABN/ACN or other Entities go to the following
links. |
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ATO,
ABR or ASIC |
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ABN/ACN of the above
business: |
* |
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(Must
be supplied or will not be registered) |
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Entity
Type: |
* |
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What
type of registration is it: |
* |
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State of the business name
registration: |
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Registrants Address Line
1: |
* |
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Line 2 |
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Line 3 |
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Suburb/Town: |
* |
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State/Province: |
* |
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Postcode/Zip: |
* |
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Country: |
* |
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Daytime Phone Number: |
* |
You can take the
option of using our c/o postal address instead of your own private
address which will be listed on the whois database for everyone to
see. Please still provide your address above.
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Yes, use my address given above
No, use the C/O
option |
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FORM SUBMISSION |
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When you submit this form, we will process it for you and you will be notified
when the hosting is available. Allow upto 2 working days for processing of com.au
names. A Tax Invoice will be sent to you, when payment has been received to
our account and cleared. |
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PAYMENT DETAILS |
PAYMENT METHOD: |
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| PAYMENT CAN BE MADE BY DIRECT DEPOSIT TO THE FOLLOWING ACCOUNT DETAILS: |
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BANK: |
Commonwealth Bank |
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ACCOUNT NAME: |
INDITECH |
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BRANCH NO: |
064817 |
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ACCOUNT NUMBER: |
1037 5384 |
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Make sure you make the deposit, or your order will not be processed.
For direct payments, make sure you make note of your domain name with your
payment. If you cannot do this, then email us the branch your payment was
made in, otherwise we will not process your order until YOU contact us.
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ALTERNATIVELY YOU CAN PAY BY CHEQUE OR MONEY ORDER
MADE PAYABLE TO INDITECH |
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N.B To prevent any problems
with accepting payments, we seek bank approval before your order has
been processed to avoid unauthorised use of cheques. If there is a
problem, we will contact you for confirmation. |
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How did you hear about Us: |
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Before you click submit, please check
all details are correct - if you make a typo you will still be billed!
You will be directed to a thank you
page when you click 'submit order'. If you do not go to this page, please email
us as we may have not received your order. |
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