Q-biz Website Builder Application Form

register this new domain name

transfer this domain name from another host

(obtain your UDAI from whoever your domain is currently registered through)

Your Quicksilver Username:
(only if you have an existing account)

Company Name

Fax number
Areacode + phone number

$99 upfront + $45 per month
(24 mth term applies**)

$399 + $20 per month

Please specify which editing mode you prefer

Simple
Advanced
I'd like access to both!

Will all email go to one mailbox, or do you require separate mailboxes?

What email addresses do you require set up?
Please specify whether each needs a separate mailbox

Information about email address and mailboxes:

A pop is a mailbox with its own username and password
An alias is an email address where email is delivered to a pop box
Take yourdomain.co.nz (a fictitious) domain name as an example:
If there are 3 people there who need their own email accounts
(call them mra, mrb and mrc) then we create 3 pop boxes with mra@yourdomain.co.nz, mrb@yourdomain.co.nz and mrc@yourdomain.co.nz.
Mr A could also be the sales person - so we could have the alias sales@yourdomain.co.nz delivered to the same mailbox as mra@yourdomain.co.nz

I have read and agree to the Terms & Conditions set out by iServe Ltd. (The Registrar), and Quicksilver Internet (The domain billing agent).
I agree to pay the annual domain regsitration charges ($49.50 per year for NZ domain), and any applicable fees as stated above.

** Early termination of the 24 month contract will incur a penalty fee of $395, or $45 x number of months remaining on the contract, whichever is less.