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Data File Backup / Remote Data Storage Sign Up Form

Step 1 Please read the service agreement. Click here to view the Service Agreement
Step 2 Fill out the form below and press submit  
Sign Up Form   
Are you a current Trakker/Trak-It Client? Yes          No
Billing Information (* Required Information)
Company Name *
Mailing/Billing Address *
Address 2
City, State  Zip * ,  . 
Contact Name *
Phone Number *   Ext.
Fax Number
Contact Information
Company Name
Your Name
Title or Position
Phone Number   Ext:
E-Mail Address
Does your company employ or sub contract a Computer Technician? Yes - Full Time     Yes - Sub Contract   No
Computer Technician's Phone Number   Ext:
Emergency Contact Name *
Emergency Contact Phone Number *   Ext:
Backup process requested Secure Internet FTP Backup
  Mail - CD / DVD / MO Drive / Tape / Other
Type(s) of files planned to be backed up
Note:  Please fill in the appropriate information for the type of service that you are signing up for.
Secure Internet FTP Backup
Requested time that the data be stored on the server prior to automatic removal:
    Note:  There will be a nightly backup and a monthly backup done.  If any files are required after they have been deleted we can restore them from an appropriate backup tape.
Number of users required (if backup by FTP) Users
Does your company currently have any FTP software? (if backup by FTP) Yes     No
Internet connection type?
Internet connection speed?
Prices   
Please select your estimated storage usage:
Note:  You will only be billed for the actual space that your files use on the server.  You can decrease this amount by compressing your files and periodic cleaning of the storage area. 
Mail - CD / DVD / MO Drive / Tape / Other
Type of Media
If Other please specify:
Length of time you wish to store media at remote location:
Where would you like your media stored?
Prices
Location Receive Retrieval
Bank Vault $10.50/Month $10.00+Shipping
Mini Storage $5.25/Month $10.00+Shipping
Payment Information
How do you wish to be billed? *
How do you wish to pay? *
Do you agree with all of the terms and conditions? *