|  | 
    
        | Order your .com, .net or .org-domaen
before someone else does it!
            ! | 
    
        | 
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        | First Name: |  | 
    
        | Last Name: |  | 
    
        | Company Name: |  | 
    
        | Telephone: |  | 
    
        | Fax: |  | 
    
        | E-mail: |  | 
    
        | Address: |  | 
    
        | Zip Code: |  | 
    
        | City: |  | 
    
        | State (Province): |  | 
    
        | Country: |  | 
    
        | 
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        | The technical informations about your provider
            or subdomaen are not necessary, if you want just to reserve a domaen name. | 
    
        | Please choose one of these choices if you want
            to connect the domaen name and a document on the web.  | 
    
        | 10 mb Web space at server of Secura for 5 US-dollars*
            per month  |  | 
    
        | Secura may choose a free sub domaen for me : |  | 
    
        | Connect the domaen with my sub domaen :
 |  | 
    
        | II want to host the domaen at my provider |  | 
    
        | First Name Server: IP-number: |  | 
    
        | First Name Server: name: |  | 
    
        | Second Name Server: IP-number: |  | 
    
        | Second Name Server: name: |  | 
    
        | 
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        | Register and connect for me at the price of
            100 US-Dollars* per year these 10 com,net or org-domains:  | 
    
    
        |  |  | 
    
    
    
        | The first registration period consists of two
            years. | 
Go to single domaen order,
if you want to order less than ten domaenen.
    
        | You can order also these domaenen: | 
    
        | from Austria | at-domains | 
    
        | from Italy like e.g. get.it!  | it-domains | 
    
        | Island-domains | Island-domains | 
    
        | 
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        | 
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        | payment |  | 
    
        | 
            
                | I pay 200 US-dollars by PayPal to secura@domainregistry.de |  |  
                | I pay 200 US-dollars cash by check |  |  
                | I send 200 US-dollars to your account
                    at |  |  
                | Stadtsparkasse Köln, Konto-Nr.2007982305
                    (BLZ 370 501 98) S.W.I.F.T.:COLS DE 33 |  |  
                | I send 220 EURO to your account at |  |  
                | Commerzbank Bremen,Konto-Nr. 1101724
                    00 (BLZ 29040090) S.W.I.F.T: COBA DE FF 290 |  |  
                | I pay the registration by. | credit
                    card |  | 
    
        | 
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        | By clicking at the button you accept our trade conditions,  Registrants rights and responsibilites and
            the Uniform Domaen
            Name Dispute Resolution Policy of the Internet authority ICANN. These documents
            are the base of the business relationship between you and Secura GmbH concerning
            domaen registration.  | 
    
        | By contract with ICANN
            we are enforced only to connect pre-paid domaenen. Please do pay at once in advance.
            You will get a bill and a confirmation about your domaen registrations.  | 
    
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