First Name:

Last Name:

Company Name:

Telephone:

Fax:

E-mail:

Address:

Zip Code:

City:

State (Province):

Country:

You can omit this paragraph, if you want only to "park" your domain.

You have four choices for the connection of your domain:

10 mb webspace with unlimited traffic and e-mail accounts on our server for 60 US-Dollars per year.

Choose free webspace without banner and pop-up window for me :

Redirect the domain to my subdomain/domain :

Primary Name Server: IP-Number:

Primary Name Server: Name:

Secondary Name Server: IP-Number:

Secondary Name Server: Name:

I order 2000 web templates for 99 US-Dollars :

Register for me this domain:

You have to pay the double price of the fee per year, if the requested registration period consists of two years.

Your space for additional orders:

You can withdraw the costs of the ordered domains from my credit card.

Credit card type:

Name on the credit card:

Credit card number

Expiration date:

Credit card issuing bank:

I pay the registration by Pay Pal to secura@web.de

By clicking at the button you accept our trade conditions, Registrants rights and responsibilites and the Uniform Domain Name Dispute Resolution Policy of the Internet authority ICANN. These documents are the base of the business relationship between you and Secura GmbH concerning domain registration.

By contract with ICANN we are enforced only to connect pre-paid domains. Please do pay at once in advance. You will get a bill and a confirmation about your domain registrations.