U-Web Internet Services Online Order Form

SEVICE REQUESTING : Web Page Compiling or Consulting
Print and send form plus Check/Money Order/Cashier Check payable to:
UWIS
6436 Bankside
Houston, TX 77096


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 : ___________________________________