Step
1
of
2
50%
What service(s) are you adding?
(Required)
New Email Services
Managed Workstation (Antivirus and Remote Monitoring)
Both Services
Name of User
(Required)
First
Last
User Email Address
Business name
(Required)
Type in your official business name.
Is this a NEW computer or repurposed computer?
(Required)
New Computer
Repurposed
If choosing repurposed, inform Galaxy IT Before it is wiped so we can remove the licensing to avoid double billing.
New Managed Workstation
Quantity
(Required)
Price:
$0.00
Quantity
New Email Services
Quantity
(Required)
Price:
$0.00
Quantity
Consent
(Required)
I understand that the pricing on this form does not reflect my final agreement and that I will be charged the full price as per my existing agreement with Galaxy IT.
Consent
(Required)
I agree to have Galaxy IT add the recommended and required services for my request.
Name of Requester
(Required)
First
Last
E-mail of Requester
(Required)
Signature
(Required)
Δ
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