DIGITAL INTERPLAY
Domain Submission Form
   
   
 
STEP 1
Please list your choice for a
domain name to be registered.

(Give a second or third choice in case your first choice is already taken.)
  Please select the extensions you
would like to register.

Each extension has a $25 fee per year.
 

1st Choice

.com
.org
.net
 

2nd Choice

.com
.org
.net
 

3rd Choice

.com
.org
.net
.
STEP 2
Contact Information
* - required fields
Name
*
Company
*
Address
*
City
*
State
*
Zip Code
+ *
Phone
-- *
Fax
--
Email

(We recomend using this email address for the domain contact [domain@yourdomainnamechoice.com]. This email address is available for anyone to see when registered.)
.
STEP 3
Billing Information - All fields must be filled out to be valid...
(This page is not yet secured, if you are uncomfortable giving this information out
please fill in phone number and we will contact you for the information.)
Credit Card Number  
Expiration Date   /
Card Holders Name  
Card Holders Billing Address  
Card Holders City  
Card Holders State  
Card Holders Zip Code   +
Card Holders Phone   --
.
STEP 4
Domain Name Requests are processed within 24 hours of being received. You will be notified by email that your requested has been accepted or denied.
Email Address to send confirmation to   
(If no email address is given we will call the Contact Phone Number from Step 2.)
.
STEP 5
    
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