RoxLab Web Hosting

ROXLAB

RoxLab Web Hosting Order Form

It is a must to fill the information about the owner of the domain even if you are reselling this server. This is required for proper registration of the domain name.

For Resellers/Partners Only:

This section is for RoxLab resellers. Please fill up this form if you are a reseller and require configuration letters to be sent to you directly. If you are not a reseller, you may skip this section.

Yes, I am a RoxLab's Reseller/Partner Or Apply Now

Reseller Organisation/Name:

Reseller Email Address:

Reseller Code No.:

Domain Name Details:

This section is required for registration of your domain name with InterNIC or other NICs.)

Domain Name: [ Check the Availability of a Domain Now! Please do not try to register yourself on www.speedname.com if you are unsure, we will do it for you.]
www. .

Administrative Contact (A person(s) representing the owner of the domain name.)

Name :

Company/Org Name:

Organization Address:

City :

State:

Postal Code:

Phone:

Fax:

Email Address :

Country:

Technical Contact (A person(s) managing the technical aspect of the domain name.)

Please Specify:

NIC:

Name :

Company/Org Name:

Organization Address:

City :

State:

Postal Code:

Phone:

Fax:

Email Address :

Country:

Billing Contact (A person responsible for money matters related to the domain name.)

Please Specify:

NIC: (If you know your NIC, you can skip this section, otherwise leave this field blank)

Name :

Company/Org Name:

Organization Address:

City :

State:

Postal Code:

Phone:

Fax:

Email Address :

Country:

Name Servers (Skip this section unless you wish to specify your own set of DNS servers.)

Primary Name Server: Primary Name Server IP:
Secondary Name Server: Secondary Name Server IP:

Others (for registration of ".sg" or ".my" domains only)

Company Registration No :

Server Details

The server features and details on all these packages and options can be found at this page.

Server Options:

Additional Features:

Standard Feature
Frontpage Extensions
ASP
PHP4
JSP
Perl
MySql

Advanced Feature (With added cost)
ASP with one DSN - S$25/year or US$15/year,
ASP with Second or more DSN at S$15/year or US$10/year
MSSQL (Will contact you for pricing)
ORACLE (Will contact you for pricing)

Additional storage space
Additional Web Storage x 10MB (Please State the Number: Each Additional 10MB is at $10/yearly)
Additional Mail Storage x 10MB (Please State the Number: Each Additional 10MB is at $10/yearly)

Other Instructions:

Additional services, if any.
* If you are registering a parked domain / virtual host, please specify here, the primary domain to point it to.
How did you hear about us ? (e.g. Straits Times Classifieds, Straits Times Comptimes, Business Times, Yellowpages, Yahoo)

Payment Details / Server Terms & Conditions

Payment Method:
Payment Terms:

Server Policies

RoxLab requires that each User to abide by the terms and conditions of the

Service Contract.
Billing Policy.
Technical Support Policy
and any relevant agreements between InterNIC, SGNIC or any NIC authorities.

Yes, I have read the terms set forth by Roxlab and agree to abide by them. In addition, by Pressing the "Submit" button below, I

authorize ROXLAB to process this server order in accordance with the terms stipulated above.
verify that the contents provided above, including payment details are accurate.
authorize ROXLAB to process my payments as specified above.

Order processing takes 1-2 business day. Your server configuration information will be sent to you via E-mail.
If you have further questions, please write to sales@roxlab.com.