MPNA . Com
Order Form!

PLEASE NOTE: The form below represents the information that must be present to insure that your Virtual Server order is processed.

IMPORTANT: If you are ordering a server that you are reselling to a client, please use the text fields found below to enter information about your client. Be sure to check the "I am reselling this server to a client" toggle box and include your reseller information in the locations provided before submitting your order.

Section 1
VIRTUAL SERVER ORDER FORM
 GENERAL CONFIGURATION
Organization Name:
Please enter the name of the organization which will be using the Virtual Server. If you are reselling this server, enter the name of your client's organization.
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:

Desired 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 separately 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 server options.
Additional Disk Space required (MB).
Cost is $1.00/MB/month.
Yes! I want mSQL Database Engine Support for my Virtual Server for $60 setup.
Yes! I want Netscape Compatible Encryption Support for my Virtual Server for $20/Month with $60 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 our Virtual Servers (check all that apply):
Reseller/Distributor
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 Administrator's Handbook
A Little Technology Shoppe offers discounts for Virtual Server resellers. These discounts can range from 5 to 30 percent! If you are a Virtual Server OEM and are reselling this server, or if you are interested in becoming a Virtual Server OEM, select the toggle box below.
I am reselling this server to a client.

Section 2
RESELLER INFORMATION
Reseller Organization Name:
Reseller Address:
City:
 Postal Address:
Country:
   United States        
State:
 Other
Province:
Country:

Reseller Contact:
Phone Number:
 FAX Number:
 Net Mailbox:

All correspondence will be sent to the reseller and NOT to the client's company. The billing can either be sent to the client or the reseller. Select the toggle below if the virtual server information (including the billing) should be sent to you, the reseller.
Send all billing information to the reseller

Section 3
BILLING AND CONFIRMATION
If you have any other questions in regard to billing, please refer to our billing information.

Please select one of the billing options below:

  Pay setup fee with the following credit card. After your order is submitted, call 860.691.3081 between 9AM and 5 PM EST to provide us with your credit card information if you are not already a registered reseller.
 
          Credit Card:
          
  Enter the phone number of the billing contact:
  Pay setup fee using other methods (please specify):
     
MPNA . Com requires that each Virtual Server System User abide by the following:
(1) The Virtual Server System shall not be used to store or disseminate obscene or pornographic material.
(2) The Virtual Server System shall not be used for gambling or any other practice deemed illegal by the laws of the State of Ohio and the US Federal Government.
(3) The Virtual Server System shall not be used to store or disseminate material of a threatening or slanderous nature.
(4) MPNA . Com reserves the right to deactivate any virtual server account, if the account is in violation of MPNA . Com operation procedures.
(5) The terms and conditions of the MPNA . Com Service Contract.
      Yes, I have read the terms set forth by MPNA . Com,
and agree to abide by them.

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@mpna.com". A sales representative will then contact you for additional information.

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Send mail to: webmaster@mpna.com with questions or comments about this web site. Copyright © 1996 MPNA . Com. All rights reserved.