SiteLeader.com
Domain Name Registration Fax Form
Please print out the form, fill it out, then fax it to (847) 501-4930

Step 1.  Check Domain Availability:  (click here to launch a new window for search)
Step 2.  Click Here to PRINT THIS FORM  (or choose print in your browser's file menu)
Step 3.  ENTER INFORMATION 
Please fill this out COMPLETELY to avoid processing delays.

First Name: ______________________________ Last Name: _______________________________________
Company/Organization (if personal site, leave blank): ______________________________________________
Street Address: _________________________________________________ City: ______________________
State/Province: _____ Zip/Postal Code: __________  Country: ______________________________________
Phone Number: __________________________ Fax Number (not required): ___________________________
Email Address: ____________________________________
How did you hear about our service?:___________________________________________________________
Are you interested in Website Hosting, Website Design, Permanent Email, and/or Domain (URL) Forwarding?
[ ]Yes  [ ]No

Step 4.  Enter up to 5 domain names you would like to register.
Please be sure to include the domain extension (.cc, .nu, .to)

Important Notes:
There is a 63 character maximum including the 4 characters used to identify the top-level domain such as .CC, .NU, .TO
May contain letters, digits, and a dash ("-").  Cannot begin or end with a dash.
Do NOT use any spaces.
Examples:     SiteLeader.to (this is a 13 character domain name)
                     4-door-sedan.nu (this is a 15 character domain name)

Domain 1: ___________________________________________________________________
Domain 2: ___________________________________________________________________
Domain 3: ___________________________________________________________________
Domain 4: ___________________________________________________________________
Domain 5: ___________________________________________________________________

I agree to pay $29.95 US to Site Leader, Inc. for each Domain name processed for registration. This will be the ONLY amount billed by Site Leader, Inc. to the credit card I have chosen above. Site Leader, Inc. will register the Domain(s) as entered above (if available). This service is strictly for Domain name registration and a standard "Coming Soon" page. I agree to pay the organization that reserves the domain name(s) I have chosen, as explained below: I understand that the organization that reserves all .CC Domain names will charge my credit card separately after the reservation of a .CC Domain is complete. It is my responsibility to pay if I have registered a .CC Domain name. The organization charges ALL .CC Domain names $60 US per year to remain reserved. I understand that the organization that reserves all .NU Domain names will charge my credit card separately after the reservation of a .NU Domain is complete. It is my responsibility to pay if I have registered a .NU Domain name. The organization charges ALL .NU Domain names $45 US per two year period to remain reserved. I understand that the organization that reserves all .TO Domain names will charge my credit card separately after the reservation of a .TO Domain is complete. It is my responsibility to pay if I have registered a .TO Domain name. The organization charges ALL .TO Domain names $100 US per two year period to remain reserved. ___________________________________________________________________ This Customer Service Agreement (“Agreement”) is made and entered into this day by and between Site Leader, Inc. an Illinois corporation (“Site Leader”) and Customer. In consideration of the mutual covenants herein, the parties agree to the following: 1. SERVICES Site Leader agrees to provide to the Customer those services which are more particularly described on Exhibit A (Site Leader Services). All services under this agreement shall be performed in accordance with Site Leader’s standard procedures, so long as such procedures do not conflict with the express terms of the Agreement. Site Leader may impose reasonable rules and regulations regarding the use of its services from time to time. 2. PRICES, TAXES Customer agrees to pay Site Leader the amounts specified on Exhibit A for services. All prices for services by Site Leader are in U.S. dollars. All payments due hereunder are net amounts to be received by Site Leader, exclusive of all taxes, duties, sales taxes, and similar taxes and duties, and are not subject to offset or reductions because of any costs, expenses, taxes, duties, assessments or liabilities incurred by Customer or imposed on Site Leader in the performance of this Agreement or otherwise due as a result of this Agreement. Notwithstanding the foregoing, Site Leader shall be responsible for the payment of any and all income taxes and income tax withholding of Site Leader. 3. ORDER ACCEPTANCE, PAYMENT All orders are subject to acceptance by Site Leader. An order will be deemed accepted by Site Leader when written confirmation of the order is sent to Customer via E-mail or fax. Site Leader may refuse to accept any order, or delay acceptance pending fulfillment of conditions Site Leader may choose to impose. Such refusal or such conditions may not be unreasonable, however, and Site Leader agrees to provide Customer with reasonable notice via E-mail or fax of any intent to delay or decline the acceptance of any order. Customer agrees to pay $29.95 US to Site Leader, Inc. for each Domain name processed for registration. Site Leader, Inc. will register the Domain(s) as entered above (only if available). For registration and security purposes, you agree to allow Site Leader, Inc. to act as your administrator. After registration has been completed, Customer understands that the applicable registrar will bill separately. It is the Customer's responsibility to pay the registrar fees. Payments are due to Site Leader upon account activation and future renewal. If due to bank charges, transfer fees, or the like, Site Leader should receive less than its invoice amount, Site Leader shall re-invoice Customer for the shortfall. Should payment in full of any invoice, save for the aforementioned shortfalls, not be received by Site Leader within thirty (30) days after account activation or renewal, Site Leader may impose a debt service charge amounting to one percent (1%) of the overdue balance for each month or fraction thereof of the overdue amount that remains unpaid. In the event that any amount remains unpaid ten (10) days after presentation of an invoice, Site Leader may discontinue, withhold, or suspend services to Customer. 4. TERM Unless earlier terminated as provided for in this Agreement, the term of this Agreement shall commence on the date of account activation and continue for the period of time shown in Exhibit A. This Agreement shall be automatically renewed for successive periods, subject to earlier termination as set forth in this Agreement, unless either party notifies the other, via E-mail or fax, on or before the thirty (30) days prior to the end of the then existing term. Either party may terminate this Agreement without notice upon the other party’s breach of any term, condition or obligation hereunder if not remedied (if remediable) (i) within ten (10) days from the date of notice, via E-mail or fax, with respect to any monetary obligation, and (ii) within thirty (30) days from the date of notice, via E-mail or fax, with regard to any other breach. 5. CUSTOMER RESPONSIBILITIES In addition to the obligations of Customer as otherwise specified in this Agreement, Customer shall be solely responsible for the following: a. Selection of products and services, including the Services, to achieve Customer’s intended results;b. The accuracy and content of any information provided by Customer to Site Leader; c. Any information, programs and other information that Customer receives as a result of the use of the Services, including, without limitation, the entire responsibility for any losses of data, programs, breaches of security, viruses, and disabling or harmful devices that Customer may download or otherwise experience as a result of Customer’s use of the Services; andd. Customer agrees to use the Services in a manner consistent with any and all applicable laws and regulations. 6. OWNERSHIP All materials, documentation, computer programs, inventions (whether or not patentable), pictures, audio, video, artistic works, and all works of authorship, including all worldwide rights therein under patent, copyright, trade secret, or other property right, created or developed by Site Leader while providing Services (collectively, Work Product) is owned by Site Leader. Work Product shall not include the Confidential Information of Customer. If ownership of all right, title, and interest of the intellectual property rights in the Work Product shall not otherwise vest exclusively in Site Leader, Customer hereby assigns to Site Leader, and upon the future creation thereof automatically assigns to Site Leader, without further consideration, the ownership of all Work Product.  7. LIMITED WARRANTY Site Leader warrants that for a period of 90 days from the date of first installation of Customer’s completed HomePage on the server described above, the coding of such HomePage shall be reasonably HTML-compliant. Notwithstanding the foregoing, the sole and exclusive remedy for a breach of the warranties contained in this Section 7 shall be that Site Leader shall replace the nonconforming coding to make such HomePage reasonably HTML-compliant. Customer acknowledges that HTML is an industry standard that contains some ambiguous provisions and that does not completely address all issues associated with the coding of Home Pages accessible via the World Wide Web. Customer also acknowledges that HTML is a standard that will be amended from time to time and that not all “browsers” used by third parties to access the World Wide Web implement HTML in the same way. Variations in HTML coding associated with ambiguities or revisions to the HTML standard or variations among World Wide Web browsers shall not be the basis for a claim of breach of Site Leader’s warranties under this Agreement. The warranties described in this section 7 are subject to the limitations of liability described below: Except as provided in this section 7, Site Leader does not make any express or implied warranties with respect to the Services or any products provided under this Agreement, including but not restricted to, the implied warranties of merchantability and fitness for a particular purpose. Some states do not allow the exclusion of implied warranties, so the above exclusion may not apply to Customer. Customer may also have other rights that may vary from state to state. 8. LIMITATION OF LIABILITY In no event will Site Leader be liable to Customer for any indirect, incidental, or consequential damages arising out of the Services or any products provided under this Agreement, even if Site Leader has been advised of the possibility of such damages. Some states do not allow the limitation or exclusion of liability for incidental or consequential damages, so the above limitation or exclusion may not apply to Customer. Site Leader’s liability to Customer for actual damages for any cause whatsoever, regardless of the form of the action, will be strictly limited to a maximum of the payments made for the prior 12 months. Customer will take all reasonable and necessary measures to preclude Site Leader from being made party to any lawsuit or claim regarding Services provided to any Customer or endorser. Customer hereby agrees to indemnify and hold harmless Site Leader from any and all claims of whatever nature brought by any of Customer’s clients or users of Customer’s HomePage against Site Leader in excess of the remedy set forth above. 9. LIMITATIONS OF SERVICE Unfortunately, computers need routine maintenance and sometimes break down; also, Site Leader cannot control the timing or volume of attempts to access Site Leader’s server. As a result, Site Leader does not guarantee that Customer or any third parties will be able to access the Customer’s HomePage at any particular time. Site Leader Services are provided on an “as-is, as-available” basis. Site Leader may discontinue service or may require the fulfillment of conditions Site Leader chooses to impose as a prerequisite for continued service. Such discontinuation or requirement may not be unreasonable, however, and Site Leader agrees to provide Customer with reasonable notice via E-mail or fax of any such intent to discontinue or impose conditions. Such discontinuation of service shall include the deletion of Customer data, including but not limited to Customer files, source codes, programs, graphics, E-mail and documents.   CONFIDENTIAL INFORMATION (a) Each party hereto shall (i) use the same care and discretion, but in no event less than reasonable care and discretion, to prevent disclosure, publication, or dissemination of the other party’s Confidential Information (defined below) as it employs with similar information of its own; and(ii) not use, reproduce, distribute, disclose, or otherwise disseminate the other party’s Confidential Information except in connection with the performance of its obligations under this Agreement. (b) As used herein the term “Confidential Information” means any and all data and information relating to the business of the disclosing party which: (i) the receiving party becomes aware as a consequence of, or through, this Agreement; (ii) has value to the disclosing party and is not generally known by its competitors; (iii) is treated by the disclosing party as confidential; and (iv) has been reduced to tangible form and marked clearly and conspicuously with a legend identifying its confidential or proprietary nature; provided, however, that Confidential Information does not include any data or information which is already known to the receiving party, or which a. has become generally known to the public through no wrongful act of the receiving party; b. has been rightfully received by the receiving party from a third party without restriction on disclosure and without, to the knowledge of the receiving party, a breach of an obligation of confidentiality running directly or indirectly to the other party hereto; c. has been disclosed pursuant to a requirement of a governmental agency or of law without similar restrictions or other protection against public disclosure, or is required to be disclosed by operation of law; d. is independently developed by the receiving party without use, directly or indirectly, of the Confidential Information received from the other party hereto; or e. is furnished to a third party by the disclosing party hereunder without restrictions on the third party’s right to disclose the information.Confidential Information may include, but is not limited to, information relating to the products, processes, or financial affairs of the disclosing party. 11. RELATIONSHIP OF THE PARTIES The relationship between Site Leader and the Customer is that of vendor and vendee. Site Leader and Customer shall not be construed as being joint ventures, franchiser/franchisee, or employer/employee. This Agreement is a commercial agreement between businesses, not a consumer agreement. Customer has no authority, apparent or otherwise, to contract for or on behalf of Site Leader, or in any other way legally bind Site Leader in any fashion, nor shall Customer be authorized to make any representations about Site Leader or its services other than to set forth Site Leader’s responsibilities as outlined in this Agreement. DISPUTES, ILLINOIS LAW The parties shall attempt to resolve all disputes arising out of this Agreement in a spirit of cooperation without formal proceedings. Any dispute which cannot be so resolved (other than the collection of money due on unpaid invoices) shall be subject to arbitration upon written demand of either party. Arbitration shall take place in Wilmette, Illinois, or at another location if the parties so agree. The arbitration shall take place before an arbitration panel chosen as follows: The parties shall each choose an arbitrator, and the two arbitrators shall choose a third arbitrator and determine the third arbitrator’s compensation. Each party shall have one veto over the choice of the third arbitrator. The three arbitrators shall schedule an informal proceeding, hear the arguments, and decide the matter by secret majority vote. Unless the arbitrators decide otherwise, each party shall pay the costs of its own arbitrator, and shall pay half of the other costs of the arbitration proceeding. Each party shall have the right to have the proceedings transcribed. The arbitrators shall not have the authority to award punitive damages or any other form of relief not contemplated in the contract. The majority of arbitrators shall render a written opinion setting forth the basis on which they arrived at the decision regarding each issue submitted to arbitration; the dissenting arbitrator, if any, shall not issue a dissenting opinion. Regarding each issue submitted to arbitration, the decision shall be final and binding only to the extent it is accompanied by a written explanation of the basis upon which it was arrived at. Judgment upon the award, if any, rendered by the arbitrators may be entered in any court having jurisdiction thereof. Should any legal action permissible under the Agreement be instituted to enforce the terms and conditions of this Agreement, in particular the right to collect money due on unpaid invoices, the prevailing party shall be entitled to recover reasonable attorney’s fees and expenses incurred at both the trial and appellate levels. This Agreement shall be governed in all respects by the laws of the State of Illinois without regard to conflict of laws provisions, and Customer and Site Leader agree that the sole venue and jurisdiction for legal actions arising from this Agreement shall be the appropriate state or federal court located in Cook County, Illinois. MISCELLANEOUS Should any part of this Agreement, for any reason, be declared invalid by a court of competent jurisdiction, such determination shall not affect the validity of any remaining portion, and such remaining portion shall remain in full force and effect. This Agreement is governed by and construed in accordance with the laws of the State of Illinois without regard to its rules governing conflicts of law. This Agreement shall be binding upon and inure to the benefit of each party and their respective heirs, successors and assigns. 14. NOTICES All notices may be sent by E-mail, fax, or express mail to the E-mail address, fax number, or address most recently provided and will be effective upon transmission. Evidence of successful transmission shall be retained. 15. ENTIRE AGREEMENT; MODIFICATIONS This Agreement sets forth the entire Agreement and understanding between the parties and merges all prior discussion between them. No representations, statements, or inducements, oral or written, not contained herein shall bind either party. Site Leader may make changes to this Agreement upon thirty (30) days’ written notice to Customer, advising of the change and the effective date thereof. Written notice shall be accomplished by posting notice of the change on the Site Leader website. Utilization of Site Leader Services by Customer and/or its Customers following the effective date of such change shall constitute acceptance by Customer of such change(s). Otherwise, this Agreement may not be modified except by the written consent of both parties. EXHIBIT A SITE LEADER SERVICES             DOMAIN NAME REGISTRATION US $ 29.95 E-MAIL FORWARDING US $ 49.00 Yearly DOMAIN NAME FORWARDING US $ 69.00 Yearly PERMANENT E-MAIL US $ 98.00 Yearly DUAL SERVICES US $ 89.00 Yearly WEBSITE HOSTING_____________________________________________________________________________ PACKAGE ONE-TIME SET UP FEE MONTHLY FEE 3mo. 6mo. 12mo. 24mo. STARTER US $19.95 US $16.95 US $50.85 US $101.70 US $203.40 US $406.80 BRONZE US $29.95 US $24.95 US $74.85 US $149.70 US $299.40 US $598.80 SILVER US $29.95 US $39.95 US $119.85 US $239.80 US $479.60 US $959.20 GOLD US $29.95 US $49.95 US $149.85 US $299.70 US $599.40 US $1198.80 PLATINUM US $29.95 US $59.95 US $179.85 US $359.70 US $719.40 US $1438.80 ULTIMATE US $29.95 US $79.95 US $239.85 US $479.70 US $959.40 US $1918.80

I have read and accepted the entire customer service agreement (Sign Here): __________________________

Step 6.  Fax this form to (847) 501-4930

That’s it!  We’ll take care of the rest and contact you by E-mail as soon as we get confirmation of the registration(s).  Thank you for using SiteLeader.com!