U-Web Internet Services Online Order Form
SEVICE REQUESTING : Web Page Compiling or Consulting
Name:________________________________________
E-Mail: _______________________________________
Company: ____________________________________
Street Address: _______________________________
City, State, Zip: ________________________________
Phone: _______________________________________
Special Instructions: _______________________________________________________________
____________________________________________________________________________________
Payment Type
_____Check, _____ Monery Order , _____ Chasier check
Check/Money Order/Cashier Check#
Service Requesting:____BILLBOARD,____Nes Ticker,____Headline
Payment Terms : per page or by the hour $10.50
Web Page Compiling  Consulting  
AMOUNT:Amount $__________ Plus tax 8.25% = $___________
Accounts Include:
Prices include page design & maintenance,Your address added to 200 search engines: One Billboard or Headlines or Ticker options. Additional options $10.00
,Additional space for a one time setup fee of $2/MB!,25,000 hits per month (Limit can be raised in 50,000 hit increments for an additional $10 per month),No initial setup fee.
Signature : ___________________________________