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	Enter a Domain Name you would like:
	Domain Name:

	Note: Domain names must consist of alpha characters, numeric characters, or the minus sign '-'. Other characters are not accepted. Domain Names are not case sensitive. Do not enter 'www' in front of the domain name. A domain which ends with .com, .net or .org can be registered automatically. Domain registration for other countries will be done on our Name Servers, but the client is responsible for contacting the NIC in the respective country to complete the registration for other countries.

	Choose one of the options below:
	Note: Choose this options if this is a brand new Domain Name which has not yet been registered:
	Please Register a new Domain for me for:
	Note: Choose this option if your domain name is already registered, and needs to be transferred to UserEasy.net.
	Please Transfer my Existing domain to UserEasy.net
	Note: Choose this option if you want to handle the Domain REGISTRATION or TRANSFER by yourself
	Don't register/transfer me (I will handle my Domain Registration/Transfer)

	Choose Username, Package and Contract Lenght:
	Username:

	Note: The Username must start with alpha characters and consist of alpha and numeric characters only (NO - _ %#@, etc). Alpha characters must be in lower case. The length of User Name should be no more than 8 characters.
	Domain Package:


	Get 10% discount with 2 year contract! Contract Length:


	How did you hear about UserEasy.net Hosting, what website on the Internet did you find us at? Your input is greatly appreciated.

	Enter the Owner Information
	First Name:


	Last Name:


	Company (or none):


	Address:


	State:


	Zip:


	Country:


	State (if other than the United States or Canada):


	Phone:


	Fax (optional):


	E-mail:

	Enter the Payment Information:
	Credit Card	Pay by Check/Money Order/PayPal
	Please input your Credit Card information below (all fields are required): Note: The address for your Credit Card must match the address you entered in previous step. Credit Card Type: Name (on Credit Card): Card Number: e.g., 4123456789101234 (no spaces, no dashes) Expiration Date:	Note, if mailing a Check or Money Order, your new Hosting Account and Domain Registration will be set up after payment is received. We now accept PayPal, click here for more info. Please send all payments (including Domain Registration fees) to: UserEasy Computer Systems, Inc. 200 Colrain SW Grand Rapids, MI 49548

	Submit
	Note: Fraudulent orders will be investigated and prosecuted, and any issued Web Hosting/Domain Registration will be automatically disabled from our server. By pressing the "Submit" button, you agree to our "Terms of Service" agreement.