Secretfield: 2534

Order Form

Arabic Language Web Site Design

How to use this Form:
  To place your order, please type 2534 in this box
Use one Form per order.
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 address as a reference.
Also, I would like to receive the FREE hosting (value $83/yr) for my new Arabic web sites.


  • The Arabic language web site is usually about 2-3 standard size print pages produced from the text and graphics from the client's main web site.
  • Production of educational Arabic web sites is available about health conditions treated at your business. Please send the title and web page address of the health conditions at your website so that to prepare a fee quote for your review.

Client  Information:

First Name   Middle Name   Family Name
Business Name
Address   City   
State Zip Code Country
E-mail Address   
Web Site Address


Build Arabic language web site:  $69 per website
FEE: Total Number of Arabic Web sites : X  $69 per web site = $


  1. USA Dollars, Checks only, no credit cards.
  2. Orders are Paid in full and in advance by checks drawn on American banks.
  3. Check Number 
  4. Payment Date   

Sending The Order Form
Please click on the method used to send your payment:
.USA Clients: 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 Clients
To avoid delays in processing your order,
please complete/send this form on line
and we will contact you for information about transferring your funds.)

>>> Please Review The completed Form before you click on "Send It in". <<<


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