| Domain Name |
| Desired Domain Name: |
New/Renew - I want to register/renew
this domain name
Existing
- I already own this domain name
Transfer
- I want to transfer this domain name to BizPartner
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| Web & Email Hosting |
| Web & Email Hosting: |
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| Free Trial: |
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You will not be charged for web & email hosting selected above.
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| Customer Details |
| Your Name / Company Name: |
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| Company Registration Number: |
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| Complete Address: |
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| Contact Person: |
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| Phone Number: |
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| Fax Number: |
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| Mobile Phone Number: |
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| Email Address: |
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| Other Details |
| Additional Information: |
Enter any further comments and instructions. |
| Duration: |
- Multi-year discount: Register 2 years for 5%
discount, 3 years for 10% discount! (not applicable to
orders from partners)
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| Preferred Payment Method: |
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| How did you get to know
us? |
Example: Google, friend referral, repeat customer etc. |
| Partner Username (if any): |
For partner: Please enter the username of your partner account if any, otherwise leave blank. |
| Promotion Code (if any): |
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| Introducer's Domain Name |
| Introducer's Domain Name: |
Disclosure - Your introducer will get 2-month free hosting for his or her domain name. Leave blank if none.
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| Declaration |
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I hereby declare that I am authorized to order on behalf of the company listed above to subscribe to the above services and that the information above is true and valid. I also agree to be bound by the hosting policy.
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