Order form for a virtual metacoon room or the hosting of a metacoon-platform

I hereby order...

...a virtual room on a metacoon platform. The monthly rent is 10 €, the one time setup-fee is 50 €. The desired room-type as well as its name, the term of lease and the support budget has to be entered in the online form below.  
...the hosting of a metacoon platform. The monthly hosting fee is 160 € (standard hosting), the one time installation fee for a platform is 450 €.  
     

order form

desired room type / basic setting for the platform*

Use a small number of common tools - Small&Easy
Use a large set of tools for cooperative learning and working - Advanced
   
 
   

term of lease/hosting:
for the next months
unlimited
   
 
 
name for your room/platform * short description of your room/platform *
   
       
  Persönliche Angaben  
       
 
 
Title* Prefix
   
first name * family name *
   
 
 
  email-address *  
   
  web-address  
   
position
   
 
 
organisation (school, company, etc) *  
   
 
 
 
  address  
   
 
 
street address *
   
 
 
zip code * city *
   
 
 
phone number.* fax
   
 
 
further information
   
 
         
 

The monthly rate and the setup fee do neither include support nor adjustments.

I would like to order hours of support. (55 Euro/h)

Support time can be used for service via phone or email or for the customization of your room/platform. All prices exlude VAT. metacoon-rooms may not be used for immoral or illegal activities.

      
         
    I agree to these terms and conditions.      
         
  Fields marked with a "*" are mandatory fields.