Virtual Private Server (VPS) or Hybrid Dedicated Server Order

Please complete this single page order form to order your Netports VPS service.

1. Your Details:
Your Name:
Your Email Address:
Business Name (if applicable):
ABN (if applicable):
Land Line Phone:
Name of Land Line Phone Listed Under:
Mobile Phone (if applicable):
Street Address:
Suburb:
Postcode:	State:

2. Choose Service:
Select Service:	Choose Service ... VIRTUAL PRIVATE SERVERS:  - VPS-1 @ $77.00 incl GST Monthly  - VPS-2 @ $132.00 incl GST Monthly  - VPS-3 @ $154.00 incl GST Monthly  ------------------------------------------------------- **SPECIAL** VPS-2 @ $99.00 incl GST Monthly  ;------------------------------------------------------ HYBRID DEDICATED SERVERS:  - HY-ECO @ $176.00 incl GST Monthly  - HY-PRO @ $242.00 incl GST Monthly   VPS = Netports Virtual Private Servers CDS = Netports Compact Dedicated Server

3. Your Domain Name:
Main Domain Name:	NOTE: If you have not registerd a domain name please do so now at: Register Domain Name

4. Desired Server Host Name:
Server Host Name:	NOTE: This will take the form of XXXX.yourdomain.com where XXXX is your chosen server host name.

5. Confirm Requirements:
Agree to Acceptable Usage Policy	YES [View Acceptable Usage Policy]
Agree to Terms Of Service	YES [View Terms Of Service]

6. Australian Website Content:
Predominenly Australian Websites::	YES NOTE: Netports supplies VPS & Compact Dedicated Server services on the condition you will be hosting predominently Australian content websites.

7. Extra Information:
Extra Information or Requirements::

8. Send Order - Make Payment:
Send Now:
	To our secure e-Path gateway to make payment