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WebPage Application

Name:
E-Mail Address:
Company Name
Complete Address:
Telephone:
What category(s) best describes your WebSite: Supplier
Teacer
WebSite Template Reqested: Item #1WS
Item #2WS
Item #3WS
Item #4WS
Item #5WS
Item #6WS
Requested Domain Name: (i.e. www.your_business.com)
I Will Be Sending A Printed Catalog To Apply To My WebSite. (recommended) Yes
No
Enter Copy as you would like it to read as your introduction on your website.
Send graphics in either .jpg or .gif format that you would like on your website. You are not limited to the uploads below. This is just a start.
Enter Billing Address if different than above:
Telephone that we can best reach you at:
Purchase Order Number:
Billing Preference: Invoice - Pay by check
PayPal - There will be a $2.00 service charge via Paypal.
I have read the fees that apply to my WebSite. I will be contacted to go over the actual pages of my site so we can determine complete costs before the design process begins. Yes
No

This form is to get your WebPage design under way. Please send any Printed material to include on your WebPage to:Internet Arts Connection4804 Logan RdAcworth, GA 30101

We will contact you to go over the development of the site.

I have read and agree to the Website advertising policy set forth below and to the Terms & Conditions. Yes
No
 

Advertising Agreement and Terms and Conditions

Advertising Agreement