| Account
Information:
|
Product
Package*
|
Please
select the
hosting package you are interested in.
- Send no money now. We will contact you for verification and
confirmation.
- For multi-year sign-ups, we will adjust the discount before invoicing. |
| Number
of Years
|
- FREE 1 year International domain name with every year of initial hosting order.
|
| Web
Design
|
Select the
web design package you need. See web design
details & pricing here.
(bundle with
hosting only)
|
| Reference Code (if any) |
|
| Send Invoice To* |
Specify who
will handle payment. For resellers, please choose
"Agent".
|
| Send Server
or Domain Info. To* |
Specify who
will receive the server configuration information.
|
| Payment Method* |
|
| |
| Agent Information:
If you are reselling this package, please complete this portion. |
| Agent Name |
|
| Agent Organisation |
|
| Agent Address |
|
| Agent Address
Line 2 |
|
| Agent City |
|
| Agent State |
|
| Agent Postal/Zip Code |
|
| Agent Country |
|
| Agent Phone |
|
| Agent Fax |
|
| Agent Email |
|
| |
| Domain
Registration Details & Customer
Information |
| Domain
Info Package* |
Beware!! of
web
hosting companies who do not register customer as the owner. Acidprint
registers customer as the rightful owner.
Please see our domain
page for pricing. Our staff will confirm the pricing via the
order confirmation.
|
| Domain* |
www .
eg. abc.com, abc.com.sg, abc.sg |
| Domain Extension* |
Please perform an availability check above. Thank you.
|
| Other Domain
Extension |
We support most domain
names. If the domain extension you want is not listed above (eg. .com.my,
.co.uk, etc).
Please select 'others' and enter your preferred domain extension
here.
|
| Domain Type |
|
| Contact Person* |
|
| Full
Organisation Name |
This
is required if you are applying on behalf of an organisation. It
is also compulsory if you are using a .SG domain.
|
RCB/ROS No.
MOE Reg No.
IDA Reg No. |
This is required
only for .SG
domain name. Enter your Business, Company or Society registration number.
For .EDU.SG, please also enter your MOE registration number. For .NET.SG
application, please also enter your IDA registration number.
|
| Address* |
|
| Address 2 |
|
| City |
|
| State |
|
| Postal/Zip Code* |
|
| Country* |
|
| Phone* |
You can
enter more than one phone number.
|
| Fax |
|
| Email* |
|
| Admin Contact* |
|
| Billing Contact* |
This is the
domain name billing contact and is relevant for .SG and other domain
name not registered with Acidprint.
If the domain name is included in the
package or purchased from Acidprint (eg. .com, .biz,
etc), we will follow the server billing contact above.
|
| Technical Contact* |
|
| |
| Remarks |
| Remarks |
If you need
to provide any special instruction or require add-ons that are not in
your package such as more space, more email a/cs, etc, please
indicate here.
For domain parking, please state the domain of the server to park at.
|
|
|
| Agreement
Declaration
|
|
Yes, I have read the terms
& conditions set forth by Acidprint and agree to abide by
them. In addition, if I am using a .SG domain, I have also read and accepted the terms for
SGNIC's agreement.
By pressing the "SUBMIT button
below, I
1. Authorize Acidprint to process this order in accordance with
the terms stipulated above.
2. Certify that the particulars given above are true and correct to my
knowledge.
Send no money now. We will confirm your order via email/phone. We
thank you for your business.
|
