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Domain Hosting Order Form (including transfers)
Domain names must consist of alpha characters, numeric characters, or the minus sign '-'. Other characters are not accepted. Domain Names are not case sensitive. Do not enter 'www' in front of the domain name.

A domain which ends with .com, .net or .org can be registered automatically.

Domain registration for other countries will be done on our nameserver, but the client is responsible for contacting the NIC in the respective country to complete the registration for other countries.

Domain Name: www.
Choose a new domain below if you are registering the domain for the first time.
New Domain Registration 
Transfer existing domain 
Don't register me (I will handle my Domain Registration)
 

***This is For New Domain Registrations Only and does not apply if you have a domain name already***
Please select the number of years for which you would like your domain registered. The fee is $35.00 per year. (hosting fees not included) If you select a registration term of more the one year, a $35.00 fee will be charged for EACH additional year.   


Choose a user login name. The user name must start with alpha characters and consist of alpha characters, numeric characters, the minus sign '-' or underline '_'. Alpha characters must be in lower case. The length of "User Name" should be no more than 8 characters.
User Name:
Domain Package:
Contract Length:

Web Hosting Monthly Quarterly Semi Annual Annual
STARTER Plan US$5.95 US$17.85 US$34.63 US$65.54
ECONOMY Plan US$9.95 US$29.85 US$57.91 US$109.45
PROFESSIONAL Plan US$19.95 US$59.85 US$116.10 US$219.45
E-COMMERCE  Plan US$34.95 US$104.85 US$203.41 US$384.45
RESELLER  Plan US$39.95 US$119.85 US$232.50 US$439.45

Comments:
Owner Information
Name (first,last):
Company/Owner:
Address:
City, State, Zipcode:
Country:
State (if other than the United States or Canada):
Phone Number:
Fax: (Optional)
E-mail (double check):
You must enter an additional e-mail address below. This address should originate outside of our network, providing us with an alternatative way to contact you via e-mail. If you do not have a second email address please use the one above. Logon and password information will be sent to both addresses.
Off Network E-mail:
InterNIC Contact Information
Please do not change this section unless you would like to fill in specific Contact information for the InterNIC registration.
Use the information above for the Administrative Contact information.
Use the information above for the Billing Contact information.
Have us be your Technical Contact.
Payment Information
Payment Type: Credit Card
Pay by Credit Card only, please input your Credit Card information.
Card Type:
Name on Credit Card:
Card number:
e.g., 4123-4567-8910-1234
Expiration date: /

Please contact us if you need help with this site or have questions or special needs, We will be glad to answer your questions.

InternicDomainNames.net provides domain registration services for your InterNic domain names.
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