Online Registration Form
Please complete this form to join our service. Fields marked with an asterisk (*) must be completed.

1.0 Your Domain Name
http://www. *
Domain type *
2.0 Company information for 'new' .com.au domain names
Only complete this section if you require a .com.au domain. If you do not require a .com.au domain please skip this section and continue with the 'Company Details' section.
Company Name   ACN
Business Name   ABN
Registered In   Business Type
2.1 Company Details
If you do not have a company or business name please enter your full name in the 'Company Name' field.
Company Name *   Phone *
Street Address 1 *   Street Address 2
Suburb *   State *
Post Code *   Country *
2.2 Your Contact Details ( password will be sent to this person )
First Name *   Surname *
Email *   Phone *
2.3 Additional Contact
If you would like another person to have the ability to change the details and configuration of your site please enter their details here. This section is optional.
First Name   Surname
Email   Phone
3. Payment Details
Please complete the payment section below. Please note that if you choose the 'Invoice Me' option an administration fee of $4.00/month or $32.00/annum will appear on your invoice. If you select the 'Invoice Me' payment method then you do not need to complete the credit card payment fields.
Payment By *   Card Number *
Card Name *   Expires *
Payment Period    
4. Comments
Please outline any details you wish us to follow in enabling your site.
Your Comments
I agree to the Techfusion's Terms & Conditions, and I would like to continue with the creation of this site.
Set up:AUD $85.00
Monthly:AUD $66.00
Annual:AUD $770.00