u-web Online order Form

U-Web Internet Services Online Order Form

SEVICE REQUESTING : LINK

Make Check/Money Order/Cashier Check payable to:
Michael C. Medellin
6436 Bankside
Houston, TX 77096

Name:

E-Mail:

Company:

Street Address:

City, State, Zip: ,

Phone:

Comments:

Payment Type Check Monery Order Chasier check
Check/Money Order/Cashier Check#

Service Requesting: LINK Payment Terms : Once per YR
PRICE : $10.00
TOTAL : $10.00

Accounts Include: Prices include alpha or logo web link, Change of alpha link, change of logo

u-web


Name:
E-Mail:
Company:
Street Address:
City, State, Zip:	,
Phone:
Comments:
Payment Type	Check Monery Order Chasier check
Check/Money Order/Cashier Check#
Service Requesting: *LINK*	Payment Terms : Once per YR PRICE : $10.00 TOTAL : $10.00
Accounts Include:	Prices include alpha or logo web link, Change of alpha link, change of logo