Adelaide IT Solutions

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Finish

Please fill in the form below to sign up. We will be in contact with you within 24 hours. (*) Denotes mandatory fields.

If you have any questions about this form or our service please contact us.

Personal Contact Information

(*)

Business Name

(*)

First name

(*)

Last name

(*)

Address

(*)

Suburb

(*)

Postcode

Phone

(*)

Services

Please select the service you require from the drop down box below. Please note yearly options are available. Please specify if you would like to pay yearly below. With the Internet Application, there is a $140 setup fee and a modem will be needed. There is no contract for the internet signup. Minimum contract period of two years for a .au domain, and one year for a .com domain.

Domain Name

Hosting

Promotion

Internet Provider

Payment Frequency

Domain Details (If Applicable)

Domain Name
ABN / ACN

Please note: ABN is needed is you have chosen a .au domain.

Promotion Details (If Applicable)

Please note: if you have selected a promotion account, these details below will need to be filled in before you promotion account can be setup.

(*)

Brief Description about your business product or service

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Domain Name

(*)

FTP Username

(*)

FTP Password

Please note: FTP details are held by your web host provider.

If you have any questions please contact us for assistance.