Domain Name Registration

Incomplete Orders will not be processed which could result in the loss of your domain name.

* If you are planning on hosting with Romore Associates and do not wish to complete this form on your own we will Register your Domain Name for you as part of your hosting package. Please contact us at support@romore.com

Registrants Name:

(Last, First)

Date of Birth:

(For Security)

Registrants E-mail:

(* If transferring a domain this address must match the current Admin E-mail address if you do not complete the Administrative section.)

Phone:

Fax:

Street Address: Resident State:
City: Zip Code:

Administrative Name:

(*If you do not complete this section the Registrants Info will be used. )

 Date of Birth:

(For Security)

Administrative E-mail:

(*If you are Transferring a domain this address must match the current Admin E-mail Address)

Phone:

Fax:

Street Address: Resident State:
City: Zip Code:

Is this a New Registration Transfer? Current Registrant:(if Known)

PLAN REQUESTED
I would like Romore Associates to host my site.* Please park my Domain name (Free)

I already have a host and have provided the Name Server Information (Below)

Requested Domain Name to Register (yourname.com)
Number of years .COM .NET .ORG ONLY: Number of years .CC ONLY:
Name Server 1: Name Server 2:
Name Server 3: Name Server 4:


* If you are planning on hosting with Romore Associates and do not wish to complete this form on your own we will Register your Domain Name for you as part of your hosting package. Please contact us at support@romore.com
Registration Fee's are nonrefundable