Please provide up to three emergency and administrative contacts. These contacts receive account information as well as maintenance and emergency notification. The people listed on this form are the only persons authorized to request and/or apporve account or service changes.
Please indicate the Junctionbox service(s) you receive from us that should use thes contacts:
Managed Server
Monitoring Services
Other: ___________________
| Contact 1 (Technical) |
Contact 2 | Contact 3 | |
| Company | |||
| Name | |||
| Mailing Address | |||
| Fax Number | |||
| Phone 1 | |||
| Phone 2 | |||
| Email Address (general mail) |
|||
| Email 2 (emergency mail) |
Junctionbox will not be held liable if a notification attempt fails due to an unannounced change in contact information.
The individuals listed below are authorized to submit modified Administrative and Emergency Contact Forms for this account. Any changes to the contact list (above) must be signed by one of the authorized individuals (below).
| Authorized Signature | Date | ||
| Printed Name | Title |
| Authorized Signature | Date | ||
| Printed Name | Title |
E-Mail to support@junctionbox.net
Copyright © 2001 Junctionbox Online Services, Inc. All rights reserved.
info@junctionbox.net / support@junctionbox.net
Junctionbox and the Junctionbox logo are registered
trademarks of Junctionbox Online Services. Certain other names, logos, designs,
titles, words or phrases on this site may constitute trademarks, servicemarks or
tradenames of Junctionbox or other entities which may be registered in certain
jurisdictions.