DOMAIN REGISTRATION
Having your own domain name is the first step towards creating an online presence. Fill in our online form and provide us with the domain names you would like to register and we will do the dirty work for you. *Required fields
Title:
I.D No.: *
First Name: *
Last Name: *
Company: *
Suburb: *
Postal Address: *
Postal Code: *
City: *
Country: *
Telephone: *
Facsimile:
Mobile:
Email Address: *

Preferred Domain 1:
Preferred Domain 2:
Preferred Domain 3:

By filling this form, you are providing Pixel Graphics with permission to order the above domain on your behalf. This include domain registration and mailbox setup. Once details have been confirmed by both parties, we will not register the domain until such time payment has been recieved. Should you wish to terminate our service you may do so in writing at any point in time. Once we have received this and your account is paid in full your domain will automatically transfered after 30 days. This is manditory as we need to ensure all data or emails are backed up.
I agree to the Terms & Condition