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T h e W e b D e s i g n e r ' s S o u r c e
f o r V i r t u a l S e r v e r s

Sign me up!	At times this form will not work. If that's the case, then send mail to "sales@wylie1.com". A Serf Texas sales representative will then contact you for additional information.

PLEASE NOTE: The form below represents the first section of information that must be present to insure that your Virtual Server order is processed. After you complete and submit the contents of this form, you will be prompted for additional information.

IMPORTANT:

Section 1

VIRTUAL SERVER ORDER FORM
GENERAL CONFIGURATION

Organization Name:
Please enter the name of the organization which will be using the Virtual Server.

Organization Purpose/Description:
Four or five word description of the organization's purpose.

Organization Address:

City:
Postal Code:

Country:
   United States
State:

Other
Province:

Country:

Organization Contact:

Phone Number:
FAX Number:
Net Mailbox:

Domain Name:
. com
net
org *Be sure to check the domain
  name availability using our
  Domain Name Check Form.
  Please be aware that Internic
  will bill you seperately for
  any name you register. The
  current charges are $100 for
  the first two years.

Server Option:
*Which server is best for you? Find out by browsing through the description of server options.

Additional Disk Space required (MB).
Cost is $5.00/MB/month.

Yes! I want mSQL Database Engine Support for my Virtual Server for $50 setup.

Yes! I want Netscape Compatible Encryption Support for my Virtual Server for $50 / month w/ $100 setup.

Other Instructions (if required):
Type any additional instructions that you would like to include with your order.

Please indicate how you found out about The Virtual Servers (check all that apply):

Tradeshow

COMDEX
Other

Newsgroup Posting

Article Review

Advertisement

Web Developer
WDVL's Spectrum
Other

iServer Reseller/Distributor

iServer Client Referral

Name of Client:

Other Sources

We will send you a complimentary copy of the Virtual Server Administrator's Handbook. You can (if you wish) choose not to receive this handbook.

Send me an Adimistrator's Handbook

Order processing takes between 3-5 business days. Your server configuration information will be sent to you via E-mail.

For billing inquiries, check out our billing page.

For those using browsers that do not support forms such as this, send mail to "sales@wylie1.com". A Serf Texas sales representative will then contact you for additional information.

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