For information call Voice 1-941-731-7554
Fax: 1-941-731-7227
Voice 1-800-708-3045 PIN#=00
E-mail:Mary Sivright at Angelfire.com
PRINT THIS FORM
If you can not print this out
Then Just Write to Us on your own stationary with this information!
Quick Web Design Order Form - Please print clearly and fill out all fields. Thank you.
Business Name
____________________________________________________
Mailing Address____________________________________________________
Street Address____________________________________________________
Telephone____________________________________________________
Fax Number____________________________________________________
Products____________________________________________________
Services____________________________________________________
Years in Business and Other Facts____________________________________________________
Persons to contact in Company and Titles ____________________________________________________
Company Slogan, Motto____________________________________________________
E-mail if already have or desired for Web Site name____________________________________________________
E-mail password desired____________________________________________________
Sub Total$95.00 per Quick Design Web Site Setup........Quantity______ ..................... $____________
Mail with payment to:
Mary Sivright, 7852 Hart Dr NE, Fort Myers, FL 33917-2444
SHIP CONFIRMATION DOCUMENTS TO:
Area Code & Phone:_______________________________
NAME:_________________________________________
STREET:_______________________________________
CITY:_______________________________
STATE:_______ COUNTRY:_______________ ZIP:___________
E-MAIL ______________________Special Instructions_______________________
Check ____Money Order(same day design)_______
Type of Credit Card:Visa____MasterCard____Discover____AmericanExpress___
Name as Shown on Card:_______________________________
Expiration Date:_______ Signature___________________________
All credit card orders will require signature acceptance
For Fastest Shipping Send Money Order
Make payable to Mary Sivright.
Thank you for your Order!!
For International Orders add extra $5.00 shipping and handling for customs and duty fees.
Please allow 10 days for International Delivery.
E-mail:Mary Sivright at Angelfire.com
