Web Hosting Subscription Form (EN)

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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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