ORDER FORM

ORDER FORM BY CHEQUE, MONEY ORDER OR CASH (Minimum $5).

.You'll receive the neccessary information of the services which you are looking out for as soon as you send this form to us with complete details.

.Information which will be provided will be charged minimum $5 each for single information.

.You will receive the information within 24 hours as soon as you send this form to us with complete details and payment.

.You'll get the information which you have ordered via e-mail.

Yes, I agree to pay total US $5 each for the information, I require for internet solutions.

Please provide me information on this(please tick mark):
Internet Solutions Registering Domain Name Website Hosting Website Design Website Design & Implementaion Website Updating Intranet Solutions
Extranet Solutions E-Commerce Solutions Internet/Intranet Security Systems-Firewalls Business Application Development Customized Business Application Development

Type of Use:
 Personal Business Student Educational

1. YOUR PERSONAL INFO :

First Name:________________ Middle Name:________________ Last Name:________________

Company__________________________________Designation___________________________

URL: http://________________________________________

Address:_________________________________________________City:_________________

State/Province:_________________Zip Code:___________Country:______________

Phone:_______________________Fax:_____________________

Email Address(Please Print)______________________________________________
(double check spelling as this is where your information of newsletter will be sent to)

2. PAYMENT TERMS:

Total amount in US $5 for information. Payment: Check_____Money Order_____Cash_____

Please print out and complete above form, mail it together with your payment (make check
payable to (Anju.B.) to:

C/o Ms. Anju.B., A.J.Internet Solutions Consultants, P.O.Box 8817, Dubai (UAE).

* As soon as we receive your payment, we'll send you the information on the internet solutions posted to you via e-mail

Thank you for helping us to help you. We will be contacting you within 24 hours.
Thank You Very Much. Good Luck!!!

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