Dedicated Servers Order Form
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PARTICULARS
E-mail Address *
Customer Name *
Address 1 *
Address 2
City *
State
Country *
Zipcode *
Phone *
Fax
Company Name
SERVER DETAILS
Server Name *
Account Password *
Server Package *
Preferred OS *
Control Panel
FEATURE OPTIONS
Connectivity Upgrade Option
Storage Upgrade Option
Memory Upgrade Option
Backup Service
Extra Bandwidth
Status2k Server Monitor Script ($2/mo.)
Remote Reboot Interface
SSL Digital Certificate
Fully Managed Service
Class C IP Block (254)
(10) IP Address Block
Justification IP Request Justification Information
As per ARIN guidelines, BurstNET™ requires justification
of your request for additional IP addresses. Failure to
justify usage of IP addresses may affect BurstNET's™
ability to obtain further IP addresses in the future from
ARIN. Typically, ARIN requires usage of 80% of your
previous allocation, prior to requesting additional IPs.
Please give details in the text area below as to you why
you require the additional IPs you are ordering/requesting,
and usage information on your previous allocation(s).
Specific Requests
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