T1-Web.com
"Websites made easy"
 


Online order form for "Do it Yourself" Website Package.
please fill out all of the information below to complete your order.


[FrontPage Save Results Component]


CONTACT INFO
( * required )

Full Name*           
Company Name   
Address*              
City* State*   Zip*
email*  
phone number*     
fax number            


WEBSITE INFO

We Can give you (1) Domain name (free)    or    transfer your existing Domain (free)
New Domain     Transfer Existing Domain

Domain to Transfer
(select below if you do not have one)


Requested domain name #1  
Requested domain name #2  
Requested domain name #3  

 

ORDER INFO

 

Basic Package Includes:

basic package    $29 (setup fee)  /  $39 month

Additional options:
automatic monthly search engine submission... additional $10/mo. 
first 3 pages built for you from one of our team members...  one time charge $99 

 

PAYMENT INFO
 

Credit Card holder information:
Name on card:   
Billing Address:  
Credit Card Type            
Exp    CCV(3 or 4 digits)