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     *Form reference IFH 1293                                  *
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                              InfininteHosts
			Hosting Application - Domains

               APPLICATION TO ESTABLISH A DOMAIN UNDER THE
                    ADMINISTRATION OF INFINITEHOSTS

      =================================================================
     |     ** TERMS AND CONDITIONS AND POLICIES OF REGISTRATION **     |
     |Domain registrations are subject to the terms and conditions as  |
     |published from time to time at http://www.infinitehosts.com      |
     |                                                                 |
     |                ** COSTS OF REGISTRATION **                      |
     |Domain registrations are subject to charges as published at      |
     |http://www.infintehosts.com/packages.php                         |
     |                                                                 |
     |                ** DOCUMENT INSTRUCTIONS **                      |
     |This document is scanned electronically so please observe        |
     |instructions regarding the document format. Do not uuencode or   |
     |send it in base64 format. Do not edit this document with a       |
     |word processor that does not leave this form in plain ascii text.|
     |                                                                 |
     |Please send only ONE APPLICATION per electronic mail.            |
     |                                                                 |
     |If you do not understand something, please contact us via email, |
     |details of which are available at                                |
     |http://www.infinitehosts.com/contact.php                         |
     |                                                                 |
     |Please Email the completed form to: hosting@infinitehosts.com    |
     |Please send any other queries to:   support@infinitehosts.com    |
     |                                                                 |
     |                ** VAT AND INVOICING **                          |
     |IMPORTANT NOTICE: All invoices pursuant to this application form |
     |will be sent electronically. By submitting this form to us the   |
     |designated Billing Contact (line 2f) hereby irrevocably agrees   |
     |and confirms that it is both willing and able to receive invoices|
     |in this format. Our invoices are not subject to VAT              |
     ===================================================================


 1. DOMAIN NAME and ACTION

    Give the name of the domain. The Action field specifies whether 
    this is a 'N'ew application, an 'U'pdate or a 'D'eletion.

    1a. Complete domain name (i.e. infinitehosts.co.uk):
    1b. Action - [N]ew, [U]pdate, Parked [P] or [D]elete :


 2. DOMAIN REGISTRANT and BILLING

    The name and postal address of the domain registrant.
    (Postal address and Street address, delimited with commas,
    on a single line please). Invoices are sent electronically.

    2a. Domain Registrant:
    2b. Initials and Surname:
    2c. I.D. Number:
    2d. Registrant Postal address:
    2e. Registrant Street address:
    2f. Suburb:
    2g. Province:
    2h. Code:

    2i. [I]nvoice or [A]ccount:
    2j. Organisation to be billed or account no. :
    2k. Email to send invoices to:

    Item 2l must contain the Postal Address for Tax Invoicing purposes.

    2l. Invoice Addr:

    2m. Registrant Phone No.:
    2n. Registrant Fax No.  :
    2o. Registrant Cellular :
    2p. Registrant e-mail   :

    2q. VAT No. for 2j :

 3. PACKAGE SIZE

    This revolves around the setup of the domain, as well as to pricing
    and structure of the domain.  

    3a. [M]icro, [H]ome, Home[P]ro, [S]tandard, [B]usiness Pro, [A]dvanced:

 4. ADMINISTRATIVE CONTACT

    It is necessary to provide details of a person who deals with the
    administrative matters of the registrant for the domains.
    (Postal address, delimited by comma's, on a single line please)
    (Phone and Fax numbers in International form - ie +27 41 391 0134)

    4a. Name (last, first):
    4b. Title/position:
    4c. Organisation:
    4d. Postal Addr:
    4e. Phone Number:
    4f. Fax Number:
    4g. Email:

 5. PAYMENT METHODS

    Please choose the payment method you would prefer for your domain.

    5a. [P]aypal:P
    
    5b. Payment must be made by clicking the appropriate PayPal "Buy Now" button. 

 6. Confirmation

    6a. Date:
    6b. Authorised Person:


    6c. Signature of 5b:         ; _________________________________

    6d. Signature is not required if filled in and sent back via email. However,
        cancellation of the domain or transfer of the domain can only be done via
        the same email account holder of the orriginal application request.


 7. Refunds

   7a. No refunds will be made for new domain registrations, or any payments 
       made by InfiniteHosts to the registrars.
   7b. Registration and or hosting fees to be paid upfront for the first month,
       thereafter, debit orders and or EFT's to be done by the 1st of each month.

    DISCLAIMER 

    InfiniteHosts does not accept responsibility or liability for the unauthorised 
    use of its e-mail facility and/or the use of its e-mail facility other than for 
    its own authorised business purposes. Save for statements and/or opinions 
    relating to bona fide company matters. InfiniteHosts denies responsibility or 
    liability for the contents of this communication. The contents of this e-mail 
    and any accompanying documentation is confidential and any use thereof, in 
    whatever form, by anyone other than the addressee for whom it is intended, is 
    strictly prohibited.



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