If applying for a Domain name please complete both pages.

LiSP
ABN 84 071 617 966

L.i.S.P Pty Ltd - Additional Internet Services
APPLICATION FORM
LiSP Pty Ltd. PO Box 114, Lithgow NSW 2790.
Phone: 02 6352 1752 Fax: 02 6353 1718

ADDITIONAL SERVICES (all fees are AU$ and are to be paid in advance)
(connection fees, web space and Internet access plans on LiSP extra - payable in advance - refer to separate LiSP Pty Ltd - Internet Access Application Form). Information on Access Usage Plans & Pricing is also available on-line at: www.lisp.com.au/about/)
TITLE: NAME: SURNAME:
BUSINESS NAME:
ADDRESS: TOWN: P/CODE:
PHONE: FAX: E-MAIL:

Service

Fee

Amount

Web Site Design & Creation: Custom made websites to your specifications. Business Packages available. From as little as $99.00 per A4 page of information including text and photos. (connection fees, web space and internet access plans on LiSP extra - payable in advance)

From $100.00
per A4 page

Web space: - first 10 meg free with purchases of an appropriate usage plan.
Up to 20 MB: $5.50 per month, Up to 50 MB $22 per month

$22 per month
per 10 MB with no current usage plan

Domain Hosting: yourcompanyname.com.au, net.au, gov.au, asn.au - With a domain name we will supply 3 Email aliases free of charge.
Domain Registration fees are additional to the Domain Hosting please refer to our (Domain Pricing)

Setup Fee $137.50
plus
Hosting $22 per month

Domain Hosting: info.au, edu.au, org.au

Setup Fee $137.50
plus
Hosting $16.50 per month

Server Hosting:
$110 per month

Email Only Domains: (Does not include connection/access)

 Setup Fee $22
$11 / month

Virtual Domain Name: eg: yourcompanyname.lisp.com.au
Includes E-mail account: alias@yourcompanyname.lisp.com.au.

Setup $110
Hosting $16.50 per month

Virtual E-mail: eg: alias@yourcompanyname.com.au - first 3 aliases free with domain name

Setup $22
$2.20 per month for additional

Additional Email Accounts:

Setup Fee $22
Rental $5.50 per month

Additional Aliases: NB: An e-mail alias must point to an existing e-mail account. It is not an e-mail account by itself.

Setup $27.50
Rental $2.20 per month

Custom Guestbook for your Website: Visitors to your website give valuable feedback. (payable in advance).

$33.00 per annum.

Guestbook Maintenance: Archiving of old guestbooks or deleting unwanted entries.

$27.50 per archive

Banner Advertising: Large Banner ie: maximum size 460 x 60 pixels - file size maximum 15,000 bytes

13.2 cents per click-through or
2.2 cents per impression

Banner Advertising: Small Banner ie: maximum size 100 x 70 pixels - file size maximum 3,500 bytes

11 cents per click-through or
1.1 cents per impression

Business Card Listing: LiSP provides a complimentary listing in the LiSP Business Index.

Setup fee $44
$11.00 per month

Website statistics: Number of Hits - Monthly, Weekly, Daily & Hourly hits. Domain Report, Directory & Requests for pages Report.

Setup fee of $27.50
$5.50 per month

WebSite Registration with Internet Search Engines: Register your site to over 1000 search engines & listings world wide. (payable in advance).

$66.00 per website

Paying by: cash cheque or money order AMOUNT: $
Paying by: Credit Card . AMOUNT: $ Card Number:
Card Type: Bankcard Visa Mastercard. Expire Date: mm/yy
Name on card: Signature:
Return your completed form, with cheque or money order, as appropriate to
L.I.S.P. Pty Ltd. PO Box 114. LITHGOW. NSW 2790. Queries - Phone: (02) 6352 1752. Fax: (02) 6353 1718
Signature Date

If applying for a Domain name please complete both pages.

LiSP

L.i.S.P. Pty Ltd - Internet Services
Domain Name Registration Form
LiSP Pty Ltd. PO Box 114, Lithgow NSW 2790.
Phone: 02 6352 1752 Fax: 02 6353 1718

The following details are required (please print):

Given Name(s) :

Surname:

Organisation Name:

Position (eg. Technical Manager):

POSTAL INFORMATION:

Street Name and Number or PO Box Number:

City or Suburb:

STATE:

Postcode (zipcode etc.)

COUNTRY:

CONTACT INFORMATION:

Phone No:

Fax No:

 E-mail address:

COM.AU Australian Domain Registration (INA) details required.

The domain name requested:

Reason: To assist the process of approval, please provide additional information supporting your application for this particular domain name, not why some domain name is needed, but there is no need to state the obvious.

Reason:

THE ORGANISATION REQUESTING THE REGISTRATION:
Name of Company ABN Legal Name / ABN Trading Name :

Organisation Postal Address:

Australian Company Number (ACN/ABN) of the Organisation:

If the domain name being sort represents a registered business name, or if no ACN exists for the Organisation, please provide:

The full Registered Business Name:

The Business Registration Number:

State of Business Registration:

Type of business: eg: Company, Pty Ltd, Partnership, Sole Trader, Incorporated Accociation etc.

I hereby authorise LiSP Pty Ltd (or LiSP Pty Ltd's Representative) to negotiate the registration of this domain name on my behalf. I understand that it is not guaranteed that this domain name will be available and that a similar name may need to be negotiated. The account for the Domain Registration will be sent to you separately, you will need to pay this when it arrives (Domain Pricing)

Signed:

Date: