PlanetDNS Canadian Order Form
Customer Information
First Name Company Address City ZIP/Postal Code Telephone E-mail Address Authorization Code State/Province Country Last Name
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The authorization code is required only when ordering PlanetDNS Standard, Pro or Enterprise services. The authorization code is available from the PlanetDNS Client software under the “Account” tab.
Service Options
Quantity Product/Service Description PlanetDNS Standard Service
PDNS-STD-D00-N01
Price (CDN $) $29.95/year $69.95/year $349.95/year $49.95/year $89.95/year $189.95/year $49.95 $69.95 Subtotal:
Total
PlanetDNS Pro Service
PDNS-PRO-D01-N01
PlanetDNS Enterprise Service
PDNS-ENT-D03-N01
5MB Mail Store & Forward Service
PDNS-STF5-D00-N01
10MB Mail Store & Forward Service
PDNS-STF10-D00-N01
25MB Mail Store & Forward Service
PDNS-STF25-D00-N01
PlanetRemote Standard
PDNS-REM-STD
PlanetRemote Plus
PDNS-REM-PLUS
Goods and Services Tax (7%) GST Registration #869243782
7% GST (required): Total Enclosed:
Payment Method
Money Order
(Please check one)
Check
MasterCard
Amex
Visa
Credit Card Information (skip if paying by check or money order)
Card Holder Name Card Number Signature
Your credit card will be billed by NewAce Corporation in Canadian dollars. The exact exchange rate will appear on your credit card statement.
Expiry Date
Please send the completed form to:
NewAce Corporation P.O. Box #456 STN MAIN Sarnia, ON N7T 7J4 Canada Fax: +1 519 336-4046
Thank You!