Reliable Consulting - Request Web Design

Request Web Design Form

Check the appropriate boxes below to match your requests.
This form may be sent in with a 50% deposit to begin your web design process.

Description	Price	Total
Register Domain Name:	$105.00
Register Extra Domain Name:	$105.00
Sign up for webspace with us	$120.00
Create a POP e-mail account:	$25.00
BASIC Web Creation	$1000.00
Create Additional Pages (Please list content in comment section below)	$50.00 / ea.
Banner Advertising	$50.00
Number of Banner links (Please list preferred links - if any - in comment section)	$25.00 / ea.
Number of Application pages (Please describe contect in comment section below)	$50.00 /ea
Grand Total

Your Name:
E-Mail Address:
Phone Number:
Additional Notes:

NOTE: 50% of grand total is required as a deposit to pay all registration fees and begin development. Balance will be due within 30 days of receipt of documentation (provided as a courtesy upon completion of project)

You may submit this form electronically, or print it and fax to 877-764-2938, or mail to:
Reliable Consulting
PO Box 601
Garden City, MI 48136

	Your first stop for all your computer consulting needs!