Home Page / Order Submission / Web Hosting and Domain Name Registration    Web hosting and domain name registration order form Please fill the following form In ENGLISH! Client information Your first name *    Last name *   Organization   Address *   Extended address (optional)   City *   State (province) *   Zip/postal code *   Country *   Telephone number including country code *   Fax number (optional)   Email * (your account information will be sent to this address)   ICQ   Prefered way to contact you: E-Mail Phone ICQ Your comments: Account information Domain name (example, mysite.com). *   com org net biz You can register and pay your domain name for a period from 2 to 10 years. Please choose method of payment. *   2 years ($33.98) 3 years ($50.97) 4 years ($67.96) 5 years ($84.95) 6 years ($101.94) 7 years ($118.93) 8 years ($135.92) 9 years ($152.91) 10 years ($169.90)   Who will be responsible for technical support of the domain? *   I myself (owner) Relmax.com   Login which you will use to manage your server (4-8 characters) *    Payment information Method of payment *   Credit card Check   Choose a hosting plan (prices per month) *   Plan 50 Plan 20 Plan 200 Plan 350 Plan 500   For what period are you paying? (Creditcards: For plan 50Mb we require a minimum lot of 3 month) *   For 1 month 3 months 6 months 1 year   Security Your Password *    Your Password (check) *    By submitting the the registration form, you agree with our "Terms". Home | Services | Portfolio | Prices | Order | Payment | Testimonials | Promotion of the Week Specials | About the Company | Links | Guest Book | Contact Information | Affiliate program Copyright © 1999-2005 Relmax Corporation. All rights reserved.