SECURE Online Application

Please complete the Domain Registration Application form below. ConcordNet Australia needs this information to process your order. Information given will be subject to our Privacy policy.

Domain registration is FREE when the customer signs up for any hosting plan. The customer may register an Australian domain name OR an international domain name. Click here for more information on how to register your domain for FREE with any hosting account. 

If you want to register a domain ONLY, please proceed and complete this form. 
= Required Fields

Australian Domain Names .com.au, .net.au, .org.au, .asn.au, .id.au
Click here to see Domain Eligibility Rules
International Domain Names .com, .net, .org, .biz, .info or .tv, are available to any individuals, organisations or companies without eligibility rules.

What is the domain that you are Registering:

Choose a purchase period:

Please complete this section if you have selected to register an Australian Domain.
If you have selected an International Domain, please go to Section 2 of this Form:-
Specify the type of your organisation? (Click the appropriate type below) 
Australian Registered Company (Pty Ltd)
Australian partnership or sole trader 
Trading under an Australian registered business name (ARBN)
Australian incorporated association 
Foreign company licensed to trade in Australia
Australian registered Trade Mark owner or applicant (TM)
Individual (.id.au domains only)

Please enter your Business Registration Number
or Association ID:

  ACN ABN VIC BN NSW BN SA BN NT BN WA BN TAS BN ACT BN QLD BN TM Association ID OTHER
 (Only if you are registering an Australian domain)

Please choose the service that you would like to purchase from the drop down list below: Note; the $39.00 set-up fee is a 1 time only payment and not charged if you are ONLY registering a domain:

Choose an Account Register and Park a Domain Only (No Charge) Register and Redirect a Domain - $55 per year + $39 set-up Register and Mask a Domain - $88 per year + $39 set-up Register a Domain & Email Addresses - $110.00 per year + $39 set-up

If you selected "Transfer and Redirect" or "Transfer and Mask", please provide us with the URL where you would like it redirected or masked:

Contact Person:

Organisation: (if Applicable)

If you are Redirecting or making a domain, what is the current address you would like it to go to: e.g. http://users.isp.com/yourname 

Phone: 

Fax: (Optional)

Street Address: 

City: 

State:

Post Code

Please enter your current Email Address: 

4. Payment Details

Payment Type:

If Credit Card payment, select card type:

Card Number:

Cardholder Name:

Expiration Date:

CVV Security Code: What is the Security Code? 

Tick here if you require an email Tax Invoice to be issued:

5. Additional Information (that we should be aware of)

How Did You Find ConcordNet? Select Google Yahoo Altavista Lycos NineMSN Looksmart The Australian Other *If other, specify