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Name: Company Name: Address: Address: City: State: Zip: Phone Number: Ext E-mail Address: I am interested in the following Voicenet Web hosting plan: Email Plan I VN Bronze Co-Located Email Plan II VN Silver Adult Email Plan III VN Gold   Email Plan IV VN Platinum   How did your hear about Voicenet? Banner Ad Radio Television Website Other How are you currently connected to the Internet? Choose 56K modem dialup ISDN DSL Cable T1 or greater Something else / Not sure No current internet connection Who is your current Internet Service Provider? Are you interested in Voicenet services for personal or business use? Personal Business If business, what type of business do you operate? Do you currently have a Web site? Yes No If yes, what is the URL? Approximately how many page are on your Web Site? pages Are you interested in hosting multiple domain names? Yes No How many email account will you need? accounts Do you require Windows NT for hosting your Web site? Yes No Do you require SSL (Secure Socket Layer) for your Web sites? Yes No Do you wish to sell items on the Internet? Yes No If yes, how many individual items? 1-49 50-99 100-499 500+ Do you require credit card processing? Yes No   Comments/Questions:

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