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 General Account?  
Bronze @ $30/Month      Silver @ $45/Month      Gold @ $60/Month
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 Business name?
 Please describe your organization (or yourself!).

Install FrontPage extensions.
CustomChat $15.00/month.
 >>Mailing & Contact Information
 Street address (1)?
 Street address (2)?


 Zip/postal code?
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 Phone number?
 Fax number (if applicable)?
 >>Domain Name Registration
 Check to see if your desired domain name is already taken by clicking here!
 Create a new domain name?
 Move domain to BuySecured.Net?
 Domain name (1st choice)?
 Domain name (2nd choice)?
 Please note that InterNIC will bill you directly for Domain name registration. The current registration
 rate is $35.00 per year and the first two years must be paid within thirty days of domain activation.

 >>Payment Information
BuySecured.Net accepts payment in the form of a check (or money order) as well as by Mastercard or VISA and Discover.

For credit card payment, you will be charged for the first month, plus a $25.00 setup fee; You will then be billed every thirty days from the activation of your Web presence for the upcoming month's service. Your account will be configured within 24 hours of the submission of this form.

 Pay via Mastercard/VISA?
 Pay via check/faxcheck/money order?
Yes. Yes.
For check or money order payment, you are asked to send payment for the first three months of service, plus a $25.00 setup fee; You will then be billed every three months for the upcoming quarter's service. You will be activated on receipt of payment. If you are in the USA and wish to get setup immediatly you may fax payment to our offices
 >>Credit Card Information
If you are paying via Mastercard or VISA, please provide your credit card information below.
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 Card Holder Name?
 Card Holder Address

 Card Holder state?
 Card Holder zip?

 >>Mailing a Check or Money Order
BuySecured.Net is a services division of Expert Data Solutions; Please make checks payable to "Expert Data Solutions" and mail to the following address:
Expert Data Solutions
a Computer Consulting Group
2310 E Ponderosa Dr #29
Camarillo, CA 93010


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