+-------------------------------------------------------+ | Celestial Enterprises | | PO Box 235 Ringwood, Victoria, 3134, Australia | +-------------------------------------------------------+ +------------------------------------------------+ |Business Domain Hosting Account Application Form| +------------------------------------------------+ * Current Business Account Information * ------------------------------------ Account Name (Current Account Name) _________________________________ Current Domain Hosting Subscription Rates: E-Mail Only hosting ------------------- .com.au (i.e. companyname.com.au) Subscription Level Duration (Years) Cost ------------------ ---------------- ------- Domain Name Registration and Delegation 2 $140.00 Domain Name Hosting 1 $ 77.00 .celestial.com.au (i.e. companyname.celestial.com.au) Subscription Level Duration (Years) Cost ------------------ ---------------- ------- Domain Name Hosting 1 $ 77.00 E-Mail and Web Domain hosting ----------------------------- .com.au (i.e. companyname.com.au) Subscription Level Duration (Years) Cost ------------------ ---------------- ------- Domain Name Registration and Delegation 2 $140.00 Domain Name Hosting 1 $165.00 .celestial.com.au (i.e. companyname.celestial.com.au) Subscription Level Duration (Years) Cost ------------------ ---------------- ------- Domain Name Hosting 1 $165.00 plus one of the following: Web Storage Space Duration (Years) Cost ------------------ ---------------- ------- Standard Storage (5 Megabyte) 1 Free 10 Megabytes Storage 1 $ 55.00 20 Megabytes Storage 1 $110.00 30 Megabytes Storage 1 $165.00 40 Megabytes Storage 1 $220.00 50 Megabytes Storage 1 $275.00 Enter Subscription Level Requested ---------------------------------- E-Mail Only E-Mail and Web Storage ----------- ---------------------- .com.au ____ .com.au ____ .celestial.com.au ____ .celestial.com.au ____ Storage Required ____ Note: All prices qouted include GST. * Agreement Information (Signature Required) * ------------------------------------------ I have read the "Celestial Enterprises Terms and Conditions of Use", and agree to abide by it. If the applicant is under 18 years of age, it must be signed by the applicants parent/guardian. In the case of the applicant being under 18 years of age, I the parent/guardian agree to be responsible for the actions of the applicant while using their account under Celestial. Date : __/__/____ Full Name (Block Letters): ________________________________________ Signed : ____________________ * Logging the Application * ----------------------- After the application form has been completed & signed. Attach a *Cheque for the full amount of the selected Subscription Level and Post to: Celestial Enterprises Attention: Registration PO Box 235 Ringwood VIC 3134 Upon receipt of the applicants form, the applicant will be notified by phone of any discrepancies within the application form and/or of the domain activation. For further queries please feel free to contact registration via Telephone (03) 9724 9661 or via Email at register@celestial.com.au * All Cheques to be made Payable to "Celestial Enterprises" * Notes to aid in application to AUNIC for Domain Hosting (AUNIC are the governing body for domain names. http://www.aunic.net). Desired domain name __________________________.com.au (name must be formed from the Company Name) Reason for requesting that particular domain name _________________________________________________________________________ _________________________________________________________________________ Full Legal Name of organisation _________________________________________________________________________ _________________________________________________________________________ Organisation Postal Address _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Australian Company Number (ACN) of the organisation _______________________________ If no ACN, explain the nature of the organisation (i.e. Why no ACN) _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ If Domain Name is a registered Business Name, or if no ACN exist, please provide The full Registered Business Name ________________________________________________________________________ The Business Registration Number _______________________________ State of Business Registration __________________ There may be other questions which may have to be answered before an application can be processed. We will contact the business in this event.