VPN Application of Interest

APPLICATION of INTEREST

Connecting to the Ada County VPN (Virtual Private Network)

Full Legal Name Of Applicant:
Dba Name (If Any):
Type Of Business:

Address:

City:

State:

Zip:

Phone:

* Your E-mail Address:

Fax:

Technical Contact:

VPN Connection Requested: Single PC † Network††

† Cisco VPN Software will be provided by Ada County, no license purchase is required. Maximum of 5 cuncurrent users.
†† Hardware VPN client must be provided by customer.

	Speed	Per Month
VPN Connection Speed*:	56k	$ 41.39
	128k	82.78
	256k	165.57
	512k	331.13
		*Applicant must agree to a (1) one-year contract, billed quarterly, in advance.

Purpose of Requested Connection:

Comments:*