Pacificnet Hosting Limited
Rm 1701-02, 17/F, ChinaChem Leighton Plaza, 29 Leighton Road, Causeway Bay, H.K .
Tel: (852) 2575-0575 Fax: (852) 2389-8852
URL: http://www.pachosting.com E-Mail: sales@pachosting.com
Internal Use
Our Ref
Client ID
Invoice No
Web Hosting Subscription Form
(Please complete the form in BLOCK letters)
Section 1. Contact Information
Company:
Address:
Contact Person:
E-mail:
Tel:
Fax:
Section 2. Service Plan
Hosting Platform:
ÜWindows Ü Linux
3-month prepayment
6-month prepayment
12-month prepayment
Add on:
Smart EmaiLink
(for China users
only)
Add on: Advanced
Anti Spam Firewall
Value - - Ü $78 x 12 = $936 Ü $48/ month Ü $25/ month
Value
Plus
- - Ü $108 x 12 = $1,296 Ü $48/ month Ü $50/ month
Gold Ü $188 x 3 = $564 Ü $179 x 6 = $1,074 Ü $169 x 12 = $2,028 Ü $58/ month Ü $75/ month
Gold
Plus
Ü $288 x 3 = $864
Ü $274 x 6 = $1,644 Ü $259 x 12 = $3,108 Ü $78/ month Ü $115/ month
Platinum Ü $498 x 3 = $1,494 Ü $473 x 6 = $2,838 Ü $448 x 12 = $5,376 Ü $150/ month Ü $175/ month
Platinum
Plus
Ü $768 x 3 = $2,304 Ü $730 x 6 = $4,380 Ü $691 x 12 = $8,292 Ü $198 / month Ü $300 / month
Diamond Ü $1,188 x 3 = $3,564 Ü $1,062 x 6 = $6,372Ü $1,006 x 12 = $12,072Ü $398 / month Ü $500 / month
Diamond
Plus
Ü $1,388 x 3 = $4,164 Ü $1,319 x 6 = $7,914Ü $1,249 x 12 = $14,988Ü $598 / month Ü $600 / month
Other
Add-On
Ü MySQL database +$50/month Ü Sitebuilder + $30/month
Ü Microsoft SQL server database +$200/month Ü Others: ________________
Ü Internet Keyword - $585 per year, PacHosting will follow up the order details and charges separately
Domain Name:
We have NOT registered the domain name above
Register the domain name above using:
Ü (.com/.net/.org - $156 per year). No. of Years: ____
Ü (.com.hk /.asia - $200 per year). No. of Years: ____
Ü (.hk - $250 per year). No. of Years: ____
Ü (.com.cn/ .cn - $400 per year). No. of Years: ____
We have registered the domain name above
Ü Transfer the domain name above with 1 year renewal
(.com/.net/.org - $156). (.hk - $250).
(.com.hk - $200). (.com.cn/ .cn - $400).
Ü Not required, we will update the DNS settings at our registrar.
Section 3. Payment
Would you prefer Pacificnet Hosting Ltd. to mail a hardcopy of invoice to you in the future?
Ü No Ü Yes, by: Üemail Üfax Üpost (HK$30 will be charged for each invoice with invoiced amount lowered than HK$500)
Payment Method
Ü By Cheque (payable to "Pacificnet Hosting Limited")
Ü By Bank Deposit - (The Bank of East Asia --- Account No: 521-40-12279-6)
Ü By Bank Deposit - (The Hongkong and Shanghai Banking Corporation Limited --- Account No: 411-086291-001)
Section 4. Additional Information
How did you know about PacHosting ?
______________________________________________ (e.g.: Search engine*, Magazine*, Friend, Email, etc. ) *please specify
I declare that all the submitted information is correct and the stated terms & conditions has been read and agreed.
_______________________________________
_______________________________________________
Authorized Signature and Company Chop
Date
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