Order Domain Name Registration (page 1)

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Hosting Order Form - page 1

Please choose from the following.

I need a domain name (Discounts are available when registering for multiple years.)

.com $14.95	.net $14.95	.org $14.95
.biz $22.95	.info $19.95	.us $19.95
.name $18.95	.mobi $59.95

I have a domain name registered somewhere else. Transfer it $25 (Adds 1 year to your domain registration)

DON'T register my domain name. (It's registered here already or I will handle the registration myself and nameservers.)

DOMAIN NAME

Check the Whois Database to see if the domain you want is available.

Domain names must consist of letters, numbers, and/or hyphens. Other characters are not accepted. Domain names are not case sensitive. Enter the domain name you want to register in the field above and choose the TLD extension.

OWNER INFORMATION

Name (person or company):

Address:

City, State, Zipcode:

, ,

Country:

State:
(if non US or Canada)

Phone Number:

(555) 555-5555

Fax:

Email:

Please enter an additional email address below. This address should originate outside of our system, providing us with an alternative way to contact you. (If you have a company, yahoo, aol, hotmail, etc email address)

Off Network E-mail:

INTERNIC CONTACT INFORMATION

Use the information above for the Administrative Contact information.

Use the information above for the Billing Contact information.

Have Hosting Connecticut be your Technical Contact.

Uncheck these ONLY to use different info for Admin, Billing, or Technical contacts, and fill in the section(s) below.

If the above options are checked, click HERE to continue

Administrative Contact Information (if different from above)

Returning customers: Use your BR number instead of filling out all the fields.

Name (first,last):

Company:

Address:

City, State, Zipcode:

, ,

Country:

State:
(if non US or Canada)

Phone Number:

(555)555-5555

Fax:

Email:

Billing Contact Information (if different from above)

Name (first,last):

Company:

Address:

City, State, Zipcode:

, ,

Country:

State:
(if non US or Canada)

Phone Number:

Fax:

Email:

Technical Contact Information (if different from above)

Name (first,last):

Company:

Address:

City, State, Zipcode:

, ,

Country:

State:
(if non US or Canada)

Phone Number:

(555) 555-5555

Fax:

Email:

Remember to choose the correct quantity of domain names on the next page, too.

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