Your Name

Your Email Address for reply contact

Your phone number (in case we have a question)

Company or Workgroup Name

Services:

Exchange Hosting:
Exchange Plus (details)
Exchange Standard (details)
Exchange Basic (details)
Mix & Match (indicate below with your list of users)

Web Site Hosting:
Yes, please host our web site
No, our web site is hosted elsewhere

Domain Name (i.e. yourdomain.com)

List of Users:
(Include First Name and Last Name)

User to be be designated as admin person, with special privileges including modifying membership of a group:

User to be designated as contact person for routine and technical communication from Exchange Hosting Service:

User to be designated as billing contact, invoices will be emailed to this user:

Email Name Pattern Selection (examples)
Exchange mailboxes can have multiple addresses, one address must be designated as the primary address of the mailbox.

List of Group Objects (aliases) needed:
Optionally, if you need info@ sales@ etc.

Billing Address (required)