Type in the Form, on
screen response, (complete applicable blanks).
Press "TAB" to move between
blank spaces.
DO NOT CLICK ON "ENTER"
while completing the form. If you do that, you will close the form and
send incomplete Form!
DO NOT press the "BACK"
button because all information will be deleted if you leave this web page.
Your Order: I would like to order the
production of Arabic language web site (Samples)
by using the following web site as a reference:
Also, I would like to receive the FREE hosting (value $83/yr) for my
new Arabic web site
Note: The Arabic language web site is usually about 2-3
standard printed pages plus graphics from the client's main web
site.
Client Information:
First
Name
Middle
Name
Family Name
Specialty/Industry
Business Name
Address
City
State/Zip Code
Country
E-mail Address
Web Site Address
Fees:
Build
Arabic language web site: $145/ea FEE: Total Number of
Arabic Web sites :
X
$145 per web page = $
PAYMENT:
USA Dollars, Checks only, no
credit cards.
Orders are Paid in full and in advance by checks drawn on American banks.
Check Number
(US Clients)
NONE
USA Clients: You may pay by wire, electronic transfer of funds
(details below).
On Line Tracking
Number (None US Clients)
Payment Date
Sending The Order
Form
Please click on the method
used to send your payment: . .USA
Orders: Please complete, then print the Order Form and mail it with your
check to: Doctors' Marketing Service P.O. Box 748
, Lake Forest, California 92609-0748
Non-USA Orders: Electronic transfer of funds:
To avoid delays in processing your order
. To
send your payment online, kindly use the following account information: DOCTORS
MARKETING SERVICE Routing
Number: 122201198 Account
Number: 11072547 Farmers
And Merchants Bank 23772 Rockfield Boulevard, Lake Forest, California 92630, USA
Also,
please send the completed form on line, click on the button below. >>> Please Review The
completed Form before you click on "Send It in". <<< .
