1 Page Web Site Order Form

1 Page Web Site Order Form - Cost: Ł99.00 + VAT per year
After we receive your order we will contact you to confirm that your details are correct and to collect the details for your web site.

Please read our term & conditions before completing this order form. If you accept and agree with them please check the box below.

I have read and agree to your terms & conditions *

All fields marked with * are required

YOUR CONTACT DETAILS
Contact Name:	*
Business name:
Address:	*
Address 1:
Town, City, or Village:	*
County:	*
Post Code:	*
Telephone number:	*
Fax number:
Mobile number:
Email address:	*
PLEASE CHOOSE A DOMAIN NAME FOR YOUR WEB SITE We will tell you if it is available or not
Domain name choice: (either .co.uk or .com)

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