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SPAM DEFENDER ENROLLMENT FORM
Organization Name:
Contact name:
Address:
City/ST/Zip:	ST Zip:
Phone:	format: 999-999-9999
Your e-mail address:
Contact me by:

SPAM DEFENDER Plans	Select one: Ultimate Access ($2.75 per mailbox) Premium Defense ($2.25 per mailbox) Critical Defense ($1.75 per mailbox)
Number of Mailboxes:
Domain Name:
IP address of e-mail server:	format: 999.999.999.999

DNS provider:
Provider Phone:	format: 999-999-9999
OPTIONS:
Extend Quarantine to 14 days	add $.10 per mailbox per month

PLEASE NOTE:	There is a $25.00 one-time setup charge. Accounts with monthly fees under $50 will be invoiced quarterly unless you pay via credit card.
Referring Technician: