VIRTUAL SERVER ORDER FORM

							               WEB SITE DOMAIN AND HOSTING ORDER FORM
                   PLEASE FAX BACK TO (02) 9618-6671.
PART 1: Customer Information

Company/Business Name : _____________________________________

ACN/Business Number :           _____________________________________

Proprietor:      Sole Trader,       Partnership,     Company,       Other _______________

Organisation Purpose/Description (few words) : ___________________________________

Admin Contact Details -

First Name: ___________________________________

Last Name:     ___________________________________

Position:      ___________________________________

Address :      ___________________________________

               ____________________Postcode:_______

Telephone : ___________________________________

Fax :          ___________________________________


Part 2: Choose Your Web Site hosting Option (NO SETUP CHARGES) –

   NO HOSTING – JUST DOMAIN NAME REGISTRATION ($200 – includes rego for 2 years)
   Hosting on Aussiecom server 20 Meg + 5 e-mail addresses - AU$40/MONTH*
   Hosting on Aussiecom server 35 Meg + 5 e-mail addresses - AU$60/MONTH*
   Hosting on Aussiecom server 60 Meg + 5 e-mail addresses - AU$80/MONTH*
   Additional e-mail addresses - $2/MONTH each (in groups of 5 only)
* These prices assume you are paying for 12 months up-front. If you wish to terminate the hosting at any
stage, Aussiecom guarantees to gladly refund the remaining money, no questions asked. If you decide to
pay monthly, there is an additional $10 monthly accounting fee.

Part 3: Choose Your Domain Name (Internet address)

Domain name : www._____________________ (LIMITED OFFER - FREE ** - $200 value!!!)
(eg. www.yourcompany.com or www.yourcompany.com.au or www.yourcompany.net …)

** To prevent people abusing this limited offer, the domain name must be hosted on the Aussiecom web
server for at least 3 months.
Part 4: Choose Your E-mail addresses

Note: You can choose to configure some (or all) of the e-mail addresses as ‘aliases’ which automatically
all e-mail to another address. eg. You could have sales@yourcompany.com.au forwarding all mail to
fred@yourcompany.com.au so all sales questions would be sent to Fred automatically.

                                                          Optional : Automatically forward e-mail to:
E-mail address 1 : ___________@yourcompany.com.au           __________@__________________
E-mail address 2 : ___________@yourcompany.com.au            __________@__________________
E-mail address 3 : ___________@yourcompany.com.au            __________@__________________
E-mail address 4 : ___________@yourcompany.com.au            __________@__________________
E-mail address 5 : ___________@yourcompany.com.au            __________@__________________
Put any additional e-mail addresses on a separate page.



Part 5: Payment Options

A) Annually or monthly?

   Pay 12 months up-front (if you decide to terminate the hosting at any stage,
Aussiecom guarantees to gladly refund the remaining money, no questions asked.)

    Pay monthly (additional $10 monthly accounting fee)

B) Direct Deposit or Cheque?

    Direct Deposit (Aussiecom will forward the bank account details to you)


    Pay by cheque
   Cheques are payable to AUSSIECOM INTERNET CONSULTING PTY LTD

Part 5: The ‘fine print’ (Aussiecom Web Site Hosting Terms and Conditions)

 Aussiecom requires that each Web site user understands and agrees to the following:
   (1) The Web site shall not be used to store pornographic material. Sites containing adult material,
   although not necessarily pornographic, are also prohibited.

   (2) These servers may NOT be used for the sending of unsolicited e-mail (spam). We have a strict
   policy of not hosting any sites that participate in "spamming". For our full policy see our web page on
   spamming.

   (3) The Web site shall not be used for gambling or any other practice deemed illegal by the laws of the
   Australian Government.

   (4) The Web site shall not be used to store or disseminate material of a threatening or slanderous
   nature.
  (5) Aussiecom reserves the right to deactivate any Web site account at any time, if the account is in
  violation of Aussiecom operation procedures.

  (6) In fairness to other users, exceptionally busy sites receiving over 1 gigabyte of data transfer per day
  (approximately 50,000 requests), must be moved to one of our dedicated servers.

  (7) Billing begins when your domain is configured and on-line. Web design is not included in the
  charges shown here.

  (8) You can cancel your hosting with Aussiecom at any time however you A) must sign and return an
  account cancellation form and B) understand that all cancellations are done on the last day of the
  month the cancellation is registered. Cancellation forms are available by contacting the Aussiecom
  Office on (02)9618 0661 during business hours.

  (9) By completing this form you accept that you are personally liable for any outstanding fees owed to
  Aussiecom Internet Consulting.

  (10) Your use of the Aussiecom server for hosting your web site constitutes acceptance of the
  Aussiecom Web Site Hosting Terms and Conditions included with the application form. You
  acknowledge that you have read this document and abide by the provisions.




                   Please check over your information then sign below.


Your signature : ___________________________________




Please fax this form back to Aussiecom Internet Consulting on
                                    (02) 9618 6671
Your website can then be hosted on the Aussiecom server immediately. The actual
domain name registration process usually takes approximately 3 days.

If you have any questions, please ring (02) 9618 0661.