Web Site Hosting

Use this form to register a new domain name. Fill it out completely with the domain name you want to register and up to 4 alternate choices. If you would rather speak to someone personally, you may *email or phone us at 1-888-875-4257.
(*When contacting us via email please be sure to include your name, telephone number, time zone and the best time to reach you.)

Domain Name To Register:
If I can't get both .com and .net go to next choice
Choice #1:	.com .net both
Choice #2:	.com .net both
Choice #3:	.com .net both
Choice #4:	.com .net both
Choice #5:	.com .net both
Your E-mail Address:

Company Information (Registrant):
Company Name:
Company Address:
City:	State:
Zip Code:
Country:
Administrative Contact Information:
Administrative Contact:	NIC Assigned Handle I don't have a NIC Assigned Handle
Name (Last):
Name (First):
Company:
Street Address:
City:	State:
Zip Code:
County:
Phone Number:
Fax Number:
E-Mail Address:
Billing Contact Information:
Billing Contact:	NIC Assigned Handle I don't have a NIC Assigned Handle Same As Administrative Contact Use the Information I provide below
Name (Last):
Name (First):
Company:
Street Address:
City:	State:
Zip Code:
County:
Phone Number:
Fax Number:
E-Mail Address:
I understand that Internic will bill me $70.00 per domain registered and that Webslinger will bill me as outlined on the rates page of this site to host my domain(s).

Webslinger, Inc.
1-888-875-4257
kmac@webslnger.com

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