AppSite Hosting: Additional IP Address Request Form

Any and all requested additional IP addresses must be applied for using the following Web form. Submissions are reviewed in a timely manner by our Support and Networking teams and will be responded to before the end of the next business day (Mon-Fri, 8:00am-6:00pm ET; excluding holidays).

Please fill out the following form fields completely. All fields are required before the form will submit properly. If you have difficulties or need assistance filling out this form correctly, please call our Dedicated Server Technical Support Team (toll free) at 1-800-627-9198 and someone will assist you with this form submission.

indicates required fields.

1. How many additional IP addresses are you requesting?

Included in your Dedicated Hosting Solution	Setup Fee	Monthly Fee
1 Additional Usable IP	$0	$0
2 Additional Usable IP's	$0	$0
3 Additional Usable IP's	$0	$0
4 Additional Usable IP's	$0	$0

Additional Options	Setup Fee	Monthly Fee
5 Additional Usable IP's	$25	$20
13 Additional Usable IP's	$25	$52
29 Additional Usable IP's	$25	$116

2. List the domains (no subdomains or unregistered domains allowed):

List the domains (no subdomains or unregistered domains allowed):

Provide a domain to IP list for the first IP address which is included.

Provide a domain to IP list or the additional IP addresses which are being requested, along with the projected usage.

*** At least 80% utilization of IP addresses is required ***

3. Name-based (shared IP address) confirmation:

Name-based (shared IP address) confirmation:

Yes, I am currently using full or partial name-based/shared IP hosting.
No, I am not using name-based hosting.

If you selected "No, I am not..." you MUST answer "3a" below)

3a. I am not using name-based/shared IP hosting methods because:

If "Other", please briefly describe:

4. For verification purposes, please supply the following information: (required)

For verification purposes, please supply the following information: (required)

Name: (ex: Jane Smith)

Domain Name: (ex: www.AppSiteHosting.com)

Daytime Phone: (ex: 512-555-4567)

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E-Mail Address: