PlanetDNS US & International Order Form

Customer Information

First Name

 

Last Name

 

Company

 

Address

 

City

 

State/Province

 

ZIP/Postal Code

 

Country

 

Telephone

 

E-mail Address

 

 

Authorization Code

 

 

 

 

 

 

 

 

-

 

 

 

 

 

 

 

 

-

 

 

 

 

 

 

 

 

-

 

 

 

 

 

 

 

 

The authorization code is required only when ordering PlanetDNS Standard, Pro or Enterprise services. The authorization code is available from the PlanetDNS Client software under the “Account” tab.

 

Service Options

Quantity

Product/Service Description

Price (US $)

Total

 

PlanetDNS Standard Service

PDNS-STD-D00-N01

$24.95/year

 

 

PlanetDNS Pro Service

PDNS-PRO-D01-N01

$59.95/year

 

 

PlanetDNS Enterprise Service

PDNS-ENT-D03-N01

$299.95/year

 

 

5MB Mail Store & Forward Service

PDNS-STF5-D00-N01

$39.95/year

 

 

10MB Mail Store & Forward Service

PDNS-STF10-D00-N01

$69.95/year

 

 

25MB Mail Store & Forward Service

PDNS-STF25-D00-N01

$149.95/year

 

 

PlanetRemote Standard

PDNS-REM-STD

$39.95

 

 

PlanetRemote Plus

PDNS-REM-PLUS

$59.95

 

 

Subtotal:

 

 

Total Enclosed:

 

 
Payment Method (Please check one)

Money Order

 

Check

 

MasterCard

 

Amex

 

Visa

 

 

Credit Card Information (skip if paying by check or money order)

Card Holder Name

 

Card Number

 

Expiry Date

 

Signature

 

Your credit card will be billed by NewAce Corporation in Canadian dollars. The exact exchange rate will appear on your credit card statement.

 

Please send the completed form to:         NewAce Corporation

P.O. Box #456 STN MAIN

Sarnia, ON N7T 7J4

Canada

                                                            Fax: +1 519 336-4046

Thank You!