exit109:: contact us

For a quote, feedback on our performance, information on our services, technical problems, whatever is important to you! Just fill in your contact information and the fields or boxes that apply below. We'll get back to you promptly. Thank you!
Contact Name:
Email address of contact:
Company Info:
Company Name:
City, State:
Web Site URL:
Do you want us to contact you by phone or email?:	email phone
Phone:
Best Time to Call:
Are you a member of exit109?	yes no
What do you wish to contact us regarding? info on services \| technical support \| tell us how we're doing

"I would like pricing and information on the below services." (check all that apply)
Dialup Access:
How many accounts?
Do you need nailed-up access?	yes no
Shell account:
How many accounts?
Web Hosting:
How many sites?
Which add-ons to our basic web hosting package are you interested in? None Additional Disk Space Front Page extensions Your own cgi/custom PERL script Secure Server Credit card authorization Shopping cart Audio/Video Password protection Other (describe):
Type of access:	ISDN T1
ISDN Access:	Dedicated Access Dial-On-Demand Access
How many simultaneous users (on your local area network)?
How many computers on your network?
Will your line location be local to either our Red Bank or Toms River exchanges? (click here to see if you are local to either POP)	yes no
Server Co-location:
How many servers?
Amount of traffic	Light Moderate Heavy
Web Design and Network Consulting:
Visit our corporate site for more information on these services.
Provide a brief description of your interest:


"I would like Technical Support to contact me."
Let us know what problems you are encountering and we will expedite a response.
Your username:
Your POP:
Your service with us:
Describe your problem:


Tell us how we are doing by answering this brief questionnaire:
Are you satisfied with our technical support?	Very Moderately Not at all
How can we improve our technical support?

Are you satisfied with our range of services?	Very Moderately Not at all
What can we add to better serve you?

Are you satisfied with our quality of services?	Very Moderately Not at all
How can we improve our quality of services?

Please provide any additional comments and suggestions below:

Don't forget: for more information about us, or for a more comprehensive overview of our services, please visit our corporate site at www.aitnj.com.