Order Form

To place your order please print out this form, fill it in and return it by fax: xxx-xxxxxx
 
Your Details:
First Name:  
Last Name:  
Company:  
Address:
  
City/Country & Post:  
Phone / Fax : Phone:............................................Fax:.....................................
Email:  
 
Products Requied:
Domain Name: Enter the domain name you require, Please also indicate whether this is a new domain or one to be transferred. Enter the domain name fee in price column.
Domain Name
Requied: 		www. your_domain_name.com (or ,com,uk)
www..........................................
New domain(..................) or Transferred(...................)
 
Products Plan:
Reseller
Basic - Lite
Enhanced - Standard
Commerce - Business
Free - A
Free - B
Budget
- A
Budget
- B
PageOne:
                 

 

 

 

 
Anuually Billing : Total usd$
Servers : Unix: .............................. Window2000:.......................
 

Payment Options: (T/T or Bank Transfer)
Bank Deposit:
.................................................................
xxx xxx xxxxxx xxxx xxxx
Terms
A agree to abide by dnsLogin's terms & privacy and Conditions.
 

 

Signature: ................................Name:.....................................Date:.................

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