Hosting Request – Pixelgate Networks

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Selected Cloud Hosting Plan

Control Panel

Note: Unless you are familiar with linux servers and/or selecting Managed Services (MRU), where we can help you, we highly recommend a Panel. Panels only be installed on new, fresh instances. They can NOT be added to an existing environment.

Managed Services (MRU)

Archived Daily VM Disk Image Backups

Note: GB Size is determined by the combined total of VM disk images associated with a live instance. Backups are available to Customer on customer prompt. Image Backups may also be automatically uploaded offsite, such as Amazon S3 or your office via special arrangement.

Selected Hosting Plan

Email Service

Yes. Enable theEconomy Email Addon - $1.00/mo
No. I already have email service elsewhere or I don't use email on this domain

Please provide us with the Domain Name you will be Hosting

Domain Name

Billing Information

Company

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number

Fax Phone

Email Address

Referral Information

Referred By

Referrer's Email

Setup Information

Initial User ID

Note: 6-16 characters. Use lowercase letter and numbers

Initial Password

Note: 6-16 characters. It is case sensitive, needs to mix case, numbers and special characters and may be changed later

Special Instructions

Please review the Terms and Conditions for the Pixelgate service. BY PRESSING “I ACCEPT” I agree that I have reviewed and accept the Terms and Conditions and understand that my use of the service will be subject to the Terms and Conditions. Your Credit Card will be charged for the 1st months service plus any setup charges that apply.