Domain Centre : Order Form

Domain Centre

Affordable, Reliable Web Hosting

Name
Surname
Domain Name	(You cannot use any of the following in a domain name: !, ?,<,>, ~, £, $, %, &, , @, #, +, / ,\ ,",.,:) Require Domain Registration (R150 for registration and R65 yearly renewal fee after the first year)* Transfer Existing Domain (R40 transfer costs and R65 yearly renewal fee after the first year since registration) Hosted Domain Parked Domain
Package Type	Core Plan (R32 p/month) Essential Plan (R57 p/month) Pay As U Need Plan (from R64 p/month)
Note / Instruction
Phone No
Fax No
Postal Address
Residential Address

	Please note that registration/ transfer will only take place once proof of payment has been received (accounts@domaincentre.co.za). Banking Details : ROSH Boundless Enterprise Trading, Standard Bank, Branch Code: 012645, Acc No: 271546417 Payment Reference : your domain name