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FIRST NAME *

LAST NAME *

TITLE *

COMPANY / DOMAIN OWNER
(FULL LEGAL NAME) *

ADDRESS *

SUITE, UNIT

CITY *

PROVINCE *

POSTAL CODE *

COUNTRY

PHONE NUMBER * as +1.1234567890

FAX NUMBER as +1.1234567890

E-MAIL ADDRESS *

DOMAIN OWNER CLASSIFICATION *
(Canadian Presence Requirement...)
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TRADEMARKED DOMAIN NAME ?
(TMA LOOKUP) TMA #:

SENTENCE ABOUT YOUR ORGANIZATION

TECH EMAIL / UNLISTED EMAIL *

NAME SERVERS (optional)
Name Server 1 Name

Name Server 1 IP Address

Name Server 2 Name

Name Server 2 IP Address

DomainLink (optional)
(URL of the website - start with http:// end with / or a file name)

DomainMail (optional)
(ISP / destination email address)

CardLink (optional)

SEND INFO ABOUT USING THIS DOMAIN NAME


NUMBER OF DOMAIN REGISTRATION YEARS *
 
METHOD OF PAYMENT *

If payment method is Banking,
please enter the Bank's name
instead of Card Number below.

Card Number:

Exp. Date:

CVV code (4 digit number on front-AmEx or 3 digit number on back-all other cards):
* CVV code required if paying by credit card
Name on Card:

Your choice of DomainLink, DomainMail or CardLink are included for one (1) year (a $50 value) FREE with every domain registration!
Choose DomainLink so visitors browsing to your domain will see your website. Choose DomainMail to receive all the email for your domain at your existing email address. Choose CardLink to give your domain name an immediate Internet presence even if you don't have a website. Services are set up immediately upon domain name registration, complete with DNS. Each additional service, add $25. 

Add DomainMail to any Link service for only $25. 

Just before submitting, take a moment to read, and agree to, the fine print. 


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