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On-Demand Web Hosting Order

To apply for HostSG On-Demand Web Hosting Services, please fill in the online form below with accurate information. The information will be kept confidential and only for HostSG use only.

Sign Up Instructions
Sections in bold denote required field, while you may skip section which has 'optional' at the top.

Domain Name Information

Please Select your Domain

Please select New Domain or Transfer:

Please enter domain name: (eg. abc.com)

Domain Name Period:

Additional Domain Information (optional)

For additional domains that you wish to register or transfer to HostSG, please type in the space provided below. Skip this section if not applicable.

Register these domains below for me
Transfer these domains below to HostSG for me

Hosting Plan Information

Select Your Web Hosting Plan

WEB HOSTING PLAN
	Web Hosting Plan	12 months fee	24 months fee	Setup Fee	Web Space
	On-Demand Web Hosting	S$10 / mth	$8.50 / mth	$0	200mb

Do you wish to purchase additional web space?

Do you wish to addon Database?

Please select your hosting operating platform

Registrant Information

Billing Address and Contact Information

Name:
Company Name:
Company Registration Number :
Primary Email Address:		Secondary Email Address:
Home Phone Number:		Work Phone Number:
Mobile Number:		Fax Number:
Address:
City:		State/Province:
Country:		Zip/Postal Code:

Billing Information

Select Your Payment Method and Service Term

Services Term :	Annually (12mths) Bi-annually (24mths)
	There will be no setup fee.
Payment Method :	Cheque/Checks Local Bank Fund Transfer (DBS/POSB) International Bank Fund Transfer (Extra S$50 surcharge) Credit Card via Paypal (rate will be charged at 0.80 USD)
	Credit Card via Paypal will be accepted for payments in USD rate at (SGD 1 = USD 0.80) [Due to transaction fees]

Please Let Us Know(optional)

General Information

Please fill in the information required to take advantage of HostSG existing customer privilege.

Are you an existing customer? :
Current Domain :

How did you found out about us? :

Comments, Remarks, Special Instructions :

By submitting this form , you are agreeing to the terms below.

:: authorize HostSG to process this server order in accordance with the terms stipulated below.

:: verify that the contents provided above, including payment details are accurate.
authorize HostSG to process my payments as specified above.

:: the terms of service, AUP, and billing policy previously set forth by HostSG.

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On-Demand Web Hosting Order

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