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  Colocation Information Request
Salutation: (e.g. Mr., Ms., Mme.):
Contact Name:*
Job Title:*
Company Name:*
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Tel. No.:*
Extension:
Email address:*
Industry:
Where did you hear about us:
Server/Equipment - Rack Mounted
Total Space (U) :
(1 U = 2.5")
Number Of Servers :
Server/Equipment - Tower
Total Space (U) :
(1 U = 2.5")
Number Of Servers :
Firewall : Yes    No
DNS Service : Yes    No
Operating System : Windows    Unix/Linux
Bandwidth Requirement (Connectivity)
Speeds :
Fast Ethernet
Full Duplex		 100 Mbps    500 Mbps 1 Gbps
Data Transfer/Month :
Power Outlets Required :
Server Managment : Yes    No
Comments:   
    

           * Are Required Fields