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Domain Name
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Desired Domain Name:
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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
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Web & Email Hosting:
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Free Trial:
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Get one-month FREE trial!
You will not be charged for web & email hosting selected above.
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Customer Details
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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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Join BizPartner mailing list to
get latest updates (click for Privacy Policy)
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Other Details
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Additional Information:
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Enter any further comments and instructions.
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Duration:
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- 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?
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Example: Google, friend referral, repeat customer etc.
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Partner Username (if any):
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For
partner: Please enter the username of your partner account if any, otherwise leave blank.
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Promotion Code (if any):
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Introducer's Domain Name (if any):
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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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