iMagine Blue - QOS 1 - Subscribe Form Version: 0.8 Dear Customer, We appreciate your business! Please fill out and return the form below to subscribe to our QOS 1 service. We will expedite your service request as soon as we get the required information. We recommend you simply reply to this message, quoting the original, and inserting your information in-line. Please note the following subscription process from this point: Once we receive the information below, we will immediately send an invoice for your first month of service. We will send this invoice either via email if that is your preferred billing method, or via both postal and email if you elect postal invoicing. You can pay the first invoice by check, money order, or credit card. Using a credit card for the first invoice will allow us setup your account right away. Our billing address for check or money orders: DATDEC PO BOX 276 WILDER VT 05088-0276 Or, to pay immediately via credit card: https://www.imagineis.com/ccinfo.jsp Please note that we will gladly refund your payment if for any reason you find your account does not meet your needs during the first month of service. Is this account a personal account or a business account? If it is a business account, please provide your business name: Your name (first and last): Please provide your or your company's complete billing address, including city, state, zipcode, and country if not within the US: Your phone number (not to be used for unsolicited sales calls): Is the above a home or work phone number? Your primary email address: Is there anyone else who you wish to have authority to alter your account? If so, please provide their name(s) and email address(es): If your address is within the US, do you prefer email invoicing or postal invoicing? Note that we send invoices via email to all International customers: Do you have a preferred UNIX username for your account? UNIX usernames must be between 5 and 8 characters, all lower case, and unique: Please list any and all domain names you wish to host with us. For example, "imagineis.com", "yourproduct.com", "yourcompany.com": Please list all subdomains with each domain name. For example, "www.yourdomain.com", "products.yourdomain.com", "development.yourdomain.com": Do you need any ".imagineis.com" subdomains? For example, "myownsite.imagineis.com" Note that we will use discretion when considering subdomains attached to our "imagineis.com" domain name. You may wish to have an imagineis.com subdomain if you either do not have a domain name of your own yet, or if would like to test your account before moving your domain name to us: Please list any email accounts and email aliases to be attached to those accounts. Email accounts are like standard UNIX accounts. They must be 5-8 characters in length, all lower case, and unique. For example, a valid email account would be "jdoe@yourdomain.com", and a "john@yourdomain.com", "johndoe@yourdomain.com", "myfriendjoe@yourdomain.com": Do you intend to use Java Servlets with your Web site(s)? Do you need any MySQL databases? If so we will need a database name and database username. Like the other usernames, the database username should be 5-8 characters in length, all lower case, and unique. The database name can be 5-64 characters, you can use mixed capitalization, but it should still be unique: Do you prefer to be able to access your database only from the server or also from your desktop computer as well? Only from the network is more secure: Please add any questions or comments you may have: For our own reference, may we ask where you heard of our services?