netINS Web Hosting
Domain Forwarding Service Registration Form
Rev: July 2004

You can use this form to point an additional domain to your existing netINS Web Hosting account. When forwarding is done, visitors to your NEW domain will see the website that exits at your CURRENT domain.

Please FAX or Mail this form to the address listed below.

  • You must have an existing netINS Web Hosting account OR you must have an existing active netINS Showcase account to forward the new domain to.
  • The new domain must be registered.
  • You will be billed $10.00 per year additional for each domain you forward to the netINS Web Hosting Account. That fee will be added on to your existing account.
  • No email service will be provided with the forwarded domains. Only the original netINS Web Hosting account will provide mail service.
  • Please print or type. We will not be able to process incomplete or illegible registrations. 
Administrative Information:

 CURRENT netINS Web Hosting Domain name OR 
 CURRENT active netINS Showcase Account:   ____________________________________
 (www.yourCURRENTdomain.com OR 
  showcase.netins.net/AREANAME)

 NEW domain name to forward to above site: ____________________________________
 (www.yourNEWdomain.com)

 2nd NEW domain name to forward to above site: ________________________________
 (www.yourNEWdomain.com)

 3rd NEW domain name to forward to above site: ________________________________
 (www.yourNEWdomain.com)

Administrative Contact:

 Name: _______________________________________________________________________

 Organization: _______________________________________________________________

 Address: ____________________________________________________________________

 City/State/Zip: _____________________________________________________________

 Daytime Telephone: _________________________ FAX: ___________________________

 Email Address: ______________________________________________________________
  **we will send your account settings to this address**

Billing Contact (IF DIFFERENT):

 Name: _______________________________________________________________________

 Organization: _______________________________________________________________

 Address: ____________________________________________________________________

 City/State/Zip: _____________________________________________________________

 Daytime Telephone: _________________________ FAX: ___________________________

 Email Address: ______________________________________________________________

Please Forward the domain(s) I've listed in the NEW domain field to my existing netINS Web Hosting service listed above. I understand that no email forwarding will be allowed for this domain. Add $10.00 yearly to my netINS Web Hosting bill.


Initial here: __________

Do you need netINS to Register Your Domain Name? If so, enter the domain name for your netINS Web Hosting Web site in the domain name blank. Some examples of web site names are: www.iastate.edu, www.apple.com, and www.netins.net

Domain Name: ________________________________

I need netINS to register my new domain name: Yes: ___ No: ___

How many years would you like to register your domain for? (Place an X next to the term you would like to have netINS register your domain for)

[   ] 1Years $20.00
[   ] 2 Years $40.00
[   ] 3 Years $44.85

If your domain name is already registered elsewhere, would you like to have it transferred to netINS control? Yes: ___ No: ___

netINS, Inc. will charge you for use of a domain name registered in the ".com", ".org", or ".net" top level domains on your first bill. Renewal notices will be sent to your administrative contact email address near the end of the term you have selected. Prices subject to change. For more information about netINS domain registration visit http://webhosting.netins.net/domainreg/. To check if the domain you want is available visit http://webhosting.netins.net/domainreg/cgi-bin/form.html

Your signature indicates:
 Acceptance of the "netINS Web Hosting Terms and Conditions" (below) -- Agreement to pay for service beginning on the day your account settings are provided to you -- If you have netINS register your domain name signature also signifies that you've agreed to the domain registration terms available at http://webhosting.netins.net/domainreg/exhibita.html.

A Signature is REQUIRED.


Signature: ____________________________________________ Date: ___________

Send this form to:

        netINS, Inc.                       FAX: (515) 830-0345
        Attn: Webmaster                    Voice: (800) 205-1110
        312 8th St., Suite 730
        Des Moines, IA 50309

netINS Internal Use Only


Customer No: __________________ Date Processed: _______

netINS Web Hosting Terms and Conditions

  1. By signing this registration form and agreement, you (customer) agree to the following terms and conditions of the service described below.
  2. These services are provided by netINS, Inc., 4201 Corporate Drive, West Des Moines, IA 50266-5906.
  3. Technical support is available upon activation of your account.
  4. All charges will be billed on your approved credit card as described on the netINS Web Hosting Registration Form. If for any reason a posting to your credit card is not accepted your service may be discontinued. An additional registration fee as well as re-establishment of valid credit will be required to re-establish service.
  5. netINS, Inc. makes no express or implied warranty of any kind. There is no express or implied warranty of merchantability or fitness for a particular purpose for the services to be provided by netINS. netINS makes no attempt to verify accurate receipt of any message and is not responsible for any loss of data resulting from delays, nondeliveries, incorrect deliveries or service interruptions, including those caused by negligence, errors, or omissions of netINS, nor for consequential damages regardless of their cause.
  6. Customer agrees to comply with the terms governing use of the netINS network, as they may change from time to time. Any changes to the terms governing use of the netINS network will be posted as warranted on the netINS computer system.
  7. This agreement shall be governed by and construed in accordance with the laws of the state of Iowa applicable to the contracts to be performed entirely within the state.
  8. Either party may terminate this agreement at any given time by giving written notice. Such notice is effective when given. Customer is obligated to pay for service through the termination date as detailed on the final invoice.
  9. By accessing and using the netINS computer system, user is consenting to system monitoring for law enforcement and other purposes. Unauthorized use of or access to this computer system may subject users to criminal prosecution and penalties. User agrees to indemnify netINS against liability for any and all use of user's account.
  10. netINS reserves the right to refuse placing materials in this account which may be deemed by netINS to be offensive to potential readers, or which may be contrary to state and federal statutes. netINS reserves the right to discontinue providing this service on your behalf for any cause deemed sufficient by netINS.
  11. By signing this agreement, you agree to absolve netINS of any liability for the content and distribution of materials placed in your area by yourself or any other persons or entities. Any questions or disputes which arise in this regard must be corresponded in writing to representatives of netINS.

All text and original graphics copyright © 2004 netINS, Inc. All Rights Reserved.