::: MIDGET SQUID : graphic design + web hosting + domain names :::

DOMAIN NAME + WEB HOSTING ORDER FORM

To register a domain name, open a web hosting account or both, please fill in the order form below. It only takes a minute! You'll then be transferred to our payment page. Once the payment process is completed you'll be signed up to Midget Squid internet services. We're sure that you'll love it!

		DOMAIN NAME & WEB HOSTING OPTIONS
		To register a domain name simply enter it in the "Domain Name (main)" box and then select whatever extension you'd like it to have. If you need more than one domain name pointing to your website, simply enter your second domain name in the "Domain Name (alias)" box and then select its extension. If you've already registered your domain name with us and would now like to order your web hosting account then simply pop your domain name in the "Domain Name (main)" box, select "change DNS" from the "Register or Transfer" option and then select the size of web hosting plan that you need. What could be easier?

Domain Name (main):		www. [check availability]
Register or Transfer:		[help]

Domain Name (alias):		www. [check availability]
Register or Transfer:		[help]

Select Web Hosting Plan:

		BILLING
		The "Billing" section is required to process payment. If you are purchasing domain names for yourself then you only need to complete this section. If you are purchasing domain names on behalf of a third party then you must also complete the "Registrant" section.

Your Organisation:
Your Name:
Your E-mail:
Your Phone Number:
Your Address:


Your Postcode:
Your Country:

Payment Method:

Register you as the owner?		yes (proceed to the "Additional Information" section below)
		no (complete the "Registrant" section below)

		REGISTRANT
		If the domain names have to be registered in someone else's name then you will also need to complete the "Registrant" section with their details.

Registrant's Organisation:
Registrant's Name:
Registrant's E-mail:
Registrant's Phone Number:
Registrant's Address:


Registrant's Postcode:
Registrant's Country:

		ADDITIONAL INFORMATION
		Please note: If you require your domain name to redirect to a different web address, please supply details of the destination domain below. All domains will be registered under your or the registrant's organisation name (rather than your or the registrant's given name) unless we are informed otherwise.

Other Info:

Promotional Code:

		TERMS & CONDITIONS
		By clicking "Submit" I indicate that I've read the Acceptable Use Policy and Terms of Service and agree to them.