ORDER FORM All fields marked with * are required. CHOOSE ONE OR MORE SERVICES Please enable Javascript in your Browser in order to correctly submit this form.WHAT DO YOU WANT TO DO?New Domain Name Registration Domain Name TransferDomain NameEnter the domain name you wish to register or transfer. There is no charge for the transfer of domain names.WEBSITE HOSTINGWebsite Hosting Package - Bronze R99 p/m (Account Setup - R350 once off)Website Hosting Package - Silver R149 p/m (Account Setup - R350 once off)Website Hosting Package - Gold R279 p/m (Account Setup - R350 once off)Website Hosting Package - Platinum R439 p/m (Account Setup - R350 once off)Account Setup Fee - R350 once off.FIRST NAME*LAST NAME*COMPANY/ORGANISATION*PHONE*EMAIL*ADDRESS*POSTAL CODE*CITY*STATECOUNTRY*MAY WE SEND YOU MARKETING AND PROMOTIONAL MATERIAL?*Yes, I would like to receive marketing and promotional material from DC Integrated Solutions.No, I do not wish to receive marketing and promotional material from DC Integrated Solutions.Submit