Product Ordering Form

 

Services to Order (Please select the appropriate service)

a) Professional Web & E-mail Hosting

b) Domain Name Registration Service (No Hosting)

c) Server Co-location

d) Dedicated Servers

e)Priority Hosting

f) Corporate E-Mail Hosting

g) MS SQL 2000 Database Hosting


2. Domain Registration Information

Domain Type New
Transfer
Domain Name

3. Background Information (Fill Either Corporate or Individual Info)

For Corporate Application
Organisation Name
Business Registration Number
Organisation Address
City
State
Postal Code
Country
Telephone
Fax
Contact Person
Designation
E-mail Address
For Individual Application
Name
NRIC
Residential Address
Email
Telephone
Fax

4. Payment Method

a) Mail Local Cheque (Payable to Intech data solution)
b) Direct Bank-in
c) Telegraphic / Wire / Bank Transfer
d) Walk-in office counter


5. Additional Information

Remarks

Please read our agreement note before submitting your order. By clicking the "ORDER" button, it is understood that you agree on our rules and regulations of our services stated on the agreement note.

Please click here to view the agreement now and then proceed to the "ORDER" button.


INTECH DATA SOLUTION (Co. Reg. : 1192683-T)
1114B, Persiaran Raja Muda Musa,
41100 Klang,
Selangor Darul Ehsan
Malaysia.

Tel : +603 - 3375 1166 / 3375 1167 / 33751168
Fax : +603 - 3374 6062
H/P: 019 - 2418456

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