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This is a Secure Order Form


Register Domain Names for $ 15.00

http://registrar4less.com
If you are setting up a new Domain a charge of  $20.00/year for Domain registration will be added to your credit card. ( There is no charge for transfer of existing Domain)  Or you can choose to signup and manage your own domain by clicking the link above. When you register your self the charges will be $15.00 /year 
Your new account will normally be activated within a few hours, and in any event no later than 24 hours on weekdays, 48 hours on weekends once we get approval of your credit card.
Please read the Terms of Service and Acceptable Use Policy 
.Domain Name Domain Type/ Contact

Click here to transfer your site yourself
Click Here to register your domain name your self		 New -Register my domain for me
 New - I will register my domain myself
Transfer-Transfer my domain for me
Transfer I will transfer  my domain myself
Alternative   Domain Name
 Your contact email address
Select a Plan - and Payment period
.
Select annual payment and have your set up fee waived
General . eCommerce Options
ASP (Free ) Merchant Account Application (Free)
Ms Access $5.00/mth Real Time Transaction $895.00*
Front Page ($5.00)/mth. Secure Certificate ($200.00/year)

Real Audio $25.00/mth.(set up $30.00)

Shopping Cart $ 10.00/mth (set up 49.00 )
Real Video $25.00/mth. (setup $30.00) ColdFusion $10/mth (setup $30.00)
CGI-BIN (Free)   Email boxes $5.00 each additional
Stats  $5.00/mth(setup $ 30.00 one time charge)

Site Promotion.
Site promotion basic ($125.00) Site promotion Advanced $2500.00(annual)
Submit your site to 400+ SE and links, one URL 4 times in the year. Billing $1460.00 at order balance in 11 monthly paymnts of $140.00/mth
*    Subject to approval

Set up information all fields are necessary
Enter e-mail address required here
 Password for email account desired
Forwarding address in any
 . Comments special instructions
Billing Information and    payment Options (select one)
Master card
Visa		 Amex
Wire Transfer (request our bank details)
Check (must pay 12months) Money Order (must  Pay 12months)
Your Name as it appears on your Credit Card
 Credit Card Number-if applicable
Street address. (credit card billing address)*
 Expire Date
Street Address 2
 Card Security Code
What is a Card Security Code?
City
 Telephone Number (Home)

State/province                 ZIP

 Telephone Number (Business)
Country
 Fax Number-Optional
*must be same as the billing address of the selected credit card when payment is made by credit card

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