Personal or Business Website Order Form:
In order to process your order please provide the following information.
Thank you
for choosing Personal Website.

All fields are required and will be sent securely.
Package Selection:
Premium Package1 (2 to 5 pages)   $199.00

Premium Package2 (6 to 10 pages) $239.00

Add Professional Package for only $200 more.
    
      We Do It All For You!
Optional Additional Elements
for Professional Package
 
Additional Graphics @ $7.00 each
Additional Pages @ $35.00 each
* Web Site or
Domain Name
 

i.e. www.your-domain-name.com

*Your Name As It  Appears On Your Credit Card:
 *Billing Address:
 

Your address where the credit card bill is mailed to.

*City:
*State/Province:
Province:
*Zip / Postal Code:
*Country:
*Phone:
*Email Address:

This Must Be A Valid Card and Number
The use of a fictitious or unauthorized card number is considered Fraud and may be subject to prosecution.

*Valid Credit Card Type:
*Valid Card Number:
*Valid Expiration Date: /
*CVV2#: see example below
*CVV2 Number

Toll Free # on Back of  Card
*You agree with 
Terms and Conditions:

  

  Your data is being sent securely.


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