Make It Design

Web Hosting Application Form

Domain Details:
New Domain?* Yes: No:  Registering For: Business: Private: 

Domain Name:
The first option will be used - the second option will be used if option 1 has already been registered

Domain Extension
.co.za .org.za .com .net .org .us .biz .info .co .me 

Company Details:
Title: Mr. Mrs. Miss. Hon. Dr. Prof. Rev. 
First Name:*
Middle Name: Last Name:*
Company Name:* Vat Number:*
Postal Address:* Suburb:
Street Address:* Suburb:
Town:* Code:*
Province:* Country:*
Telephone (w):* Fax (w):*
Telephone (h):* eMail Address:*

Terms And Conditions:

I, named in the above form, hereby acknowledge to make use of the Web Hosting service provided by Make It Design. I, named in the form above, agree that I will take responsibility for the hosting account and that I will be responsible to make a monthly payment to Make It Design on an amount which was agreed and that Make It Design reserves the right to take steps if I fail to pay my account.
I, named in the above form, hereby also acknowledge that I will notify Make It Design one calender month (30 days) in advance if I feel the need to cancel or transfer my hosting account to another Web Hosting company. I agree that I will be held responsible for the outstanding account for the month remaining if I do not fulfill abovementioned obligation.
I agree to the Tems And Conditions

* Denotes required fields