Backup Express - Sign Up - Online Backup - Offsite Backup - Internet Backup - Data Backup

Use this form to sign up with Backup Express by filling out all Company , contact details.

Select the submit button at the end to forward the form to BackUp Express.

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Company Details
Company Name:
ABN/ACN:
Contact Name:
Street Address:
City:
State:
Post Code:
Postal Address:
City:
State:
Post Code:
	Same as street address
Phone:
Fax:
* Email:
Optional Email Addresses:
Technical:
This address will receive a copy of technical notifications and announcements.
* You must enter a valid email address. Your account information will be sent to this address.

Primary Account:
Storage Quota			! Help me choose !
Select	Plan	Storage Quota	Cost Per Month(inc GST)
	ExpressValue 19	10 GByte	$19
	ExpressValue 29	15 GByte	$29
	ExpressValue 39	25 GByte	$39
	ExpressValue 59	50 GByte	$59
	ExpressValue 89	100 GByte	$89
	ExpressValue 129	250 GByte	$129
	ExpressValue 199	500 GByte	$199
	ExpressValue 249	750 GByte	$249
	ExpressValue 299	1000 GByte	$299
Additional Computer Licenses - Click here to see if this is relevant to you
	Additional computer licenses		$5

Preferred User Name
Username: (min 6, max 20 characters)		Create your own unique User Name to enable access to your account with BackUp Express

Restore Window	! Help me choose !
Required restore window	1 month 3 months 6 months

Additional Plugins
If required add the optional plugins
	Add Local Backup functionality - backup to Tape, Disk, NAS or CD/DVD. Includes Disaster Recovery ($10/month inc GST)

Total Monthly Cost
$	I understand this is the monthly cost (Note: No minimum commitment is required).

Additional Services and Savings
	I will pay annually in advance and receive 12 months for the price of 11 months

Where did you hear about us?
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Promotions:
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Other Comments

All new accounts include the first 14 days as a free trial. You may use the service free of charge and with no obligation during that time.
Billing will commence automatically 14 days after account activation unless you cancel the account by notice in writing to us prior to that time.
Invoices will be sent to you at your nominated email address and are payable in 14 days. Payment may be made via cheque, back transfer or credit card. See 'Payment Methods'.

I agree to the terms and conditions