Document Sample
 Received Date:
 Process Date:
 Receipt No:

 Surname *
 Given Name/s *
 Company Name
 Street Address *
 City *
 State *                                                                        Postcode *
 Country *
 Telephone No*
 Email Address *
 (no free email addresses)
 Alt. Email Address
 (additional email address)



                               Please refer to for domain name availability.


       I will handle my own domain name registration or transfer
       Please register this domain through iPlug Hosting

       .com 1 year ($19.00)                                      2 year ($59.95)
       .net 1 year ($19.00)                                      2 year ($35.00)
       .org 1 year ($19.00)                                      2 year ($37.00)
       .biz 1year ($19.00)                                       2 year ($15.00)
       .info 1 year ($19.00)                                     1 year ($19.00) 2 year ($59.95)                                            other – email us

       Use my information for the administrative contact
       Use my information for the billing contact information
       Have us be your technical contact

ABN 62 896 415 537                                           Pg 1                                     Initials

 10% Discount for those who are registering for 12 months or more.
       Student – Silver Plug ($2.95 per month)                         Business - Bronze Plug ($4.95 per month)
       Student – Gold Plug ($4.95 per month)                           Business - Silver Plug ($7.95 per month)
       Student – Platinum Plug ($7.95 per month)                       Business - Gold Plug ($13.95 per month)
                                                                       Business – Platinum Plug ($24.95 per month)


       3 Months                                                        12 Months (10% Discount)
       6 Months                                                        24 Months (10% Discount)

       1 year                                                          2 years

                       (A random password will be generated for your account and will be emailed to you)



                             Please calculate the total payment you will be making to iPlug Hosting.

                Domain Name *      $
      Web Hosting Package *        $
                       TOTAL *     $

ABN 62 896 415 537                                           Pg 2                                                    Initials

Policy and Service Guidelines

We provide web hosting to many clients, and we have a responsibility to protect each client and to provide the best services
available. The following guidelines were designed to ensure these obligations are met.


All services provided may be used for lawful purposes only. Transmission, storage, or presentation of any information, data or
material in violation of any Australian or U.S.A. Federal or State law is prohibited. This includes, but is not limited to: copyrighted
material, material we judge to be threatening or obscene, or material protected by trade secret and other statute. The subscriber
agrees to indemnify and hold us harmless from any claims resulting from the use of the service which damages the subscriber or any
other party.

Pornography is prohibited. Both iPlug Hosting and our providers will be the sole arbiter in determining violations of this provision. Also
prohibited are sites that promote any illegal activity or present content that may be damaging to our servers or any other server on
the internet. Links to such materials are also prohibited.

Examples of unacceptable content or links:
• Spamming
• Pirated software
• Hacker programs or archives
• Warez sites
• Sites with pornographic content

We will be the sole arbiter as to what constitutes a violation of this provision. Any violation is subject to a penalty of up to US$1,000.
-  Disclaimer - iPlug Hosting and our network providers are not responsible for any damages caused by services provided, and
   makes no warranties of any kind, expressed or implied for services we provide.
-  Commercial Advertising - Email: Spamming, or the sending of unsolicited email, from our server or using an email address or
   domain that is maintained on our machine as reference is STRICTLY prohibited. We will be the sole arbiter as to what
   constitutes a violation of this provision. Any violation is subject to a penalty of up to US$1,000.
-  Background Running Programs: We may allow programs to run continually in the background. These are considered on a case-
   by-case basis and an extra charge will be incurred based on system resources used and operational maintenance needed.
-  IRC: We currently do not allow IRC or IRC bots to be operated on our servers.
-  Server Abuse: Any attempt to undermine or cause harm to a server, or customer is strictly prohibited. Any violation is subject to a
   penalty of up to US$1,000.
-  Refusal of Service: We reserve the right to refuse, cancel, or suspend service at our sole discretion.
   All accounts and customers using our services must adhere to the above policies. Failure to follow any term or condition will be
   grounds for immediate account deactivation.


Customers who are on recurring plans are due for automatic billing from their credit card approximately 14 days prior to the
anniversary of their sign up date, and every period thereafter, on or about the same day of the month.

If your credit card information has changed, then you must notify us immediately so we may change this information. If on your bill
date, your credit card is declined, or payment is not received on the due date, your account may be interrupted temporarily and an
email will be sent to the address on file to notify you of this problem. If payment is not arranged within 14 days, we will close your
account, and any files will be lost.

For Free Trial offers, we require sign-up for three months and your credit card number. At the end of the trial period, if you do not
advise us otherwise, we will debited your credit card for 3 months' hosting.

All prices are in Australian (Au$) payments made by Australian clients are subjected to 10% GST.

Credit Card Payments

We do not accept Credit Card Payments at this time.


If for any reason you are not satisfied with our services, please let us know. We build our services around making hosting simple for
the customer and want you to be happy. If for some reason we cannot meet your needs, you must notify us in writing and we will
discontinue billing your account at the end of your current bill cycle. We require seven days notice of any cancellation. No refunds are
issued for hosting services already paid.

ABN 62 896 415 537                                              Pg 3                                                           Initials
New domain registrations

New domain registrations are final once submitted. However, you may transfer your domain to another provider if you wish. Once you
have submitted your order for a domain name it is registered and not reversible, and we cannot refund the domain registration
charges. To transfer or modify domain information, email us. If a domain is not available or taken before our system can register it,
we will notify you and offer to register another domain or refund the registration charges. You should note the Uniform Domain Name
Dispute Resolution Policy from ICANN before registering a new domain ( under
the heading “Domains”).


We are not responsible for backing up your web files. It is solely your responsibility. We provide a facility on your Control Panel
("Backup") for downloading your backup. This should be done daily. Your data is precious, protect it as such.

Data Transfer

Additional data transfer is billed at US$3.00/Au$6 per 1000 Megabytes/month (or portion thereof). When you exceed, or are about to
exceed, we will attempt to send you a courtesy e-mail. We are not responsible for checking on your account daily and if you exceed,
you are still responsible for your usage charges. You may elect to change to a different hosting plan during the bill cycle (we prorate
changes mid-cycle) to help cover usage, however, you must remain on that new plan for at least 30 days. If you do not change to
another plan, you are charged the fee above. We cannot make exceptions to this for any reason, including not sending you a
courtesy email.

If you have any questions regarding our policies or services, please contact us at the following email: .


         I understand that iPlug Hosting will provide technical support via email or any means stated by iPlug Hosting

         I have read the iPlug Hosting Terms of Service and agree to abide by them. I also understand iPlug Hosting will invoice you
         for the amount of any fees incurred by any breach of these terms. This must be paid within a strictly given time. Absolutely
         no refunds will be given in these circumstances.

         I understand that details of this transaction are being recorded.

         I have read and initialled each page of this application form.

Please mail your completed application form and make payment using either one of the following methods:

1)     Money order to iPlug Hosting.
2)     Bank Cheque made payable to iPlug Hosting
3)     Direct Deposit to the following account details:           Account Name: IPLUG HOSTING
                                                                  BSB Number: 112-879
                                                                  Account Number: 464562546

Please mail money order/ bank cheque and completed application forms to:
                                                            iPlug Hosting
                                                            PO Box 180
                                                            Bonnyrigg NSW 2177

         ____________________________                                        ___________________________
         Customer’s Full Name (Printed)                                      Customer Signature


         ____________________________                                        ___________________________
         Witness Full Name (Printed)                                         Witness Signature


ABN 62 896 415 537                                              Pg 4                                                           Initials