Domain Name Registration

Before registering a domain, please check its availability.

Please fill out the form carefully, and completely, and feel free to call us if you have any questions.

Dotster (the domain registrar) charges a fee to register your .com .net and .org domain names. New domains such as the .tv .biz .wc and .cc are subject to higher pricing. Please contact Internet Nebraska for current prices on these domains.

All fields must be filled out. For example, use N/A if a field is not applicable for the current situation.

Internet Nebraska can also host your domain. Take a look at our Web Hosting Prices.

Is this a:
New Domain Registration
Transfer Request

Domain Name:
Register for: (Paid to Dotster)

Contact Information:
Contact Person:
Organization Name:
Address:
City: State:
Zip:
Phone:
Fax:
Email:

Choose One of the Following. Internet Nebraska will send invoices to your email unless noted otherwise
Domain for Email only (No Web Hosting)
     Free (i.e. No hosting charge, but you must still purchase the domain)
Where should we forward Email sent to your domain?
Forwarding Email (user@host.com):

Create Standard Web Hosting Account (500 MB disk / 10000 MB transfer, $50 Startup Fee)
     Standard - 1 month $25
     Standard - 6 months $99
Create Premium Web Hosting Account (1000 MB disk / 25000 MB transfer, Secure Transactions, 25 POP3 email accounts, $75 Startup Fee)
     Premium - 1 month $35
     Premium - 6 months $149
Choose Billing Method for the Webhosting Services
     Email - We will send an email invoice to the email address listed above each time the account needs to renew
     Invoice - Paper invoices cost $1 to send out, and will be sent to the address listed above
     Credit Card - With this option, the credit card you use to purchase the domain will be charged automatically to renew the webhosting.
Choose your preferred Operating System (Unix or NT)
    Unix     NT

Please Choose a 3 to 14 letter username for your account Username:

Password Security Question
This will be used to verify your identity if you need to call us to obtain the password.

Question:		Custom Question:	

Answer:

Are you running your own server? We can redirect your domain to an IP you specify
No
Yes, Domain or IP:

Domain Payment (Paid to Dotster, Internet Nebraska will bill to the Billing Contact's email address, unless noted otherwise). Unfortunately, Internet Nebraska cannot charge this to your current account. Payment must be made with a credit card.

Card Type: Number: Exp Date (mm/yy): Name as Appears on Card: Verification Number: We also need to know the address to which the Credit Card bill is sent, as well as the phone number listed on the credit card account: Address: City: State: Zip: Phone Number:

Notes (optional):

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