Blue Moon Internet Services

Business Pricing Quote Request

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Company Contact Information
Company Name *
Company Contact EMail *
Contact Individual Name *
Contact Phone Number (w/area code and ext.)
    * = required field
Desired Services   (Select all which apply, ignore those which don't)
Dialup Access
Number of Dialup Accounts (Buffalo local calling area)
Number of POP EMail Accounts (accessed through dialup account or existing internet connection)
Website Hosting
If you are moving a website, what is the site's current URL?
What Domain Name(s) do you have or would you like to have? (skip if you won't have a domain name)
Do you need to register your domain name? (skip if you don't want your own domain name) No   Yes
Do you need Domain EMail Forwarding? (skip if you won't have a domain name) No   Yes
How much storage space do you need for your website?

None   5 MB   10 MB   20 MB   50 MB 100 MB   100 to 499 MB   Over 500 MB  

Do you need a SSL (encrypted connection) capable server? No   Yes
Do you need MySQL Database access? No   Yes
Do you expect your site to have a high level of traffic? No   Yes
Please provide a short description of what your website's purpose will be: (if requesting a website quote)
Additional Information
Please provide any additional information about your specific needs or ask questions here:
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