First State Internet Services Order Form

Please note: Although it is most unlikely that you will experience
any problems responding to this form, certain non-standard browsers 
will not respond properly. If you experience any difficulties, (or if you 
are not using a forms-capable browser) you may e-mail your response 
to this form to:Webmaster@thefirststate.com

       
Please Enter Your Name: Required

Please Enter Your E-mail Address: Required

Please Enter Your Mailing Address: 


Please Enter Your Contact Number 

Check What type of Server Package your ordering below.

Premier Server/Corporate $75.00/Setup - $40.00/Monthly
Premier Server/Non-Profit Organization $25.00/Setup  -  $35.00/Monthly
Super Server/ $75.00/Setup - $69.95/Monthly
Total Server/ $75.00/Setup -  $105.00/Monthly

Once we receive your order your account will be
activated after payment is received by us in the mail.

All accounts are billed Quarterly.

Please Enter The $$$ Amount: 

Any Questions or Comments E-mail us 

Make checks payable to:
First State Internet Services
103 Beech Lane
Wilmington, DE 19804
Phone: 302-996-0598
Fax: 302-996-0573

     
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