Acquisition Information Form
	SecureWebs is actively seeking to acquire other web hosting accounts, both dedicated or virtual. If you own a company that provides Web hosting or rents servers and are interested in selling to a reputable firm, please fill out the form below. Your information will be handled in the strictest of confidence.  It is the basic information need to start a dialog on if there is a opportunity for the selling and buying companies to come to terms.    Name:   Title: Company: Phone Number: Email Address: Web Site URL:   Country         Number of Dedicated Servers: Of these, how many are Co-Location Servers:     Number of Virtual Accounts Percentage of UNIX versus Win2K hosting     Additional Information, such as the average monthly charge for an account and other such information you think is pertinent: