Web Hosting Signup Form

Your Business Web Hosting Plan

 
 

What Username would you like?

Desired Username *
Usernames can be no more than 8 characters and must NOT begin with a number
Password *
Confirm password *
 

Contact Details

Your First Name *
Your Last Name *
Your Date of Birth DD/MM/YYYY *
Physical Address  
Your Company Name
(if applicable)
Address 1 *
Address 2
City *
Country *
Phone Number * (eg: 64-4-1234567)
Fax Number
Current Email Address *
 

Billing Details

Same as above If different, complete fields below
Address 1 *
Address 2
City *
Country *
 

Payment Information

Please let us know how you would prefer to pay your Orcon account.

Important: if you are signing up for a paid plan, an invoice will be generated when you click the "join Orcon" button for which you will be liable to pay.
If you choose to pay with your Credit Card, we currently accept Master Card and Visa.
 
  Direct Debit
(New Zealand Based Customers Only)
  Credit Card
 

Finished

Click the button below when you have completed the form.

Please check that you have filled in all the appropriate fields.

If you are paying by Direct Debit, the authority form will be e-mailed to you. Please ensure that you print it out, fill it in and return it as soon as you receive it.
 
 

Talk to us now

talk to us now
Sales
Freephone: 0800 144 737
Helpdesk
Freephone: 0800 144 737
Online enquiries
Email: The Orcon team