Order Form for Sub Domain Name


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Free Domain Name Order Form

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You will be able to have a FREE sub domain name from Internet Communication Services Mauritius, e.g. yourname.yourdomainnamechoice.com, if you take the hosting services from ICSM for a minimum contract of 1 year.

Order Form for Domain Name
*	Compulsory Field
Domain Information
	yourname		yourdomainnamechoice.com
*		.
	yourname2
*		.
	yourname3
*		.

Personal Information
*	Last Name
*	First Name
*	E - Mail Address
*	Confirm E - Mail Address		Note: ICSM has a strict privacy policy. We do not sell or give away personal information. See our Privacy Policy for details.
*	Telephone
	Fax

Company Information
	Company Name
	Web site
	Address
	City/Locality
	Country

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Free Domain Name Order Form

Order Form for Domain Name

*

Domain Information

Personal Information

Company Information