IVYCOM ORDER FORM

Please fill out this form completely and press the "ORDER" button.

If you have any questions, please call us at
502-419-0381
or send email to sales@ivycom.com

* Required fields are marked by "*" symbol.

Account Information
Domain Name (Enter without www. in front)*
www.
New Domain Existing (already registered)

(Choose "Existing" if you have registered your domain name with Register.com.)

Yes, please handle the domain name registration or transfer in my behalf. If you have already registered your domain name at a registrar such as namesecure or godaddy or parked your domain name with IVYCOM.com, please uncheck this box

(For domain transfers, make sure you enter your company name below exactly as it is listed with the InterNIC.  If you have already registered your domain name this does not apply.)

*Please note that we cannot guarantee the securing of the domain name as InterNIC is the final arbiter of such matters.  However there is a very high probability that  it is available if the search on our website has returned it as being available.

 

 Plan Type*

 

Check here if you want Microsoft FrontPage extensions loaded for this account

 

Subscriber Information
First Name*
 Last Name*

Company Name/Organization Name*

IMPORTANT: If you do not have a company name, please type in your full name.

Phone*
 		Fax

E-mail Address*

Please provide an email address different from the one at your domain name.

Second E-mail Address

 Address - Line 1*

Address - Line 2

City*
, 		State*
 		Zip*

Country *

How did you hear about us?*

Referrer
If you were referred by another IVYCOM member, enter their domain name above.  This will enable them to receive referral credit. You too can receive referral credit by spreading the word after you signup.  In order for this to work, you should have chosen "Referral by Existing Customer" in How did you hear about us? above.