Nostix products and services

Online domain registration form

Please complete the form below and click on submit to apply for a domain registration.

Company/Entity:
Last Name:
First Name:
Postal Address:
Street Address:
Phone no:
Fax: no
Cell no:
Company Registrasion no:
Company VAT no:
ID no:
Domain Name	www
Owner Email:
New Mailbox Name: 1 Mailbox id include free:	@
Extra charge @ R28,50 mailbox:
Extra Mailbox Name:	@
Extra Mailbox Name:	@
.co.za (R148,20)
com (R336,30)
General Terms and conditions apply.
1 .All the above fields are required for registration purposes.
2. Should payment not be received by the 15th of the month, the connection could be terminated until payment is received.
3.Termination of this domain and hosting will occur automatically after 1 year from registration date which means that the domain cannot be terminated before that period of time. The owner must renew the domain after that period of time in order to keep the domain live.
4. All amounts include VAT.
5. It is necessary to provide details of a person who carries the responsibility for administrative and policy matters of the organization above.
6. Please note that one email account is included in registration fee, any additional mailboxes are charged at R28.50 per mailbox.

18 Dirkie Uys Street Wilgehof, Bfn, 9301

P.O. Box 31114
Fichardt Park, 9317

Tel: +27 (0) 51 522 3400
Fax: + 27 (0) 86 610 4812

member of the phatshoane henney group of associated firms.