:: WEB DESIGN ADULT ::

OWN YOUR OWN WEB CAM WEBSITE ORDER FORM

Fill out form below with a down payment of 50% and we will get you started on owning your own web cam website.

CLIENT INFO

First Name:

Last Name:

Address:

City:

State:

Zip Code:

Email:

Home Phone:

Work Phone:

Cell Phone:

INFO NEEDED FOR SUBMISSION

Desired Website Name:	Domain Name is not guaranteed. We will check website name with Network Solutions to see if domain is available.
Choose Site Option

TERMS & CONDITIONS

By filling out this form you give Web Design Adult to charge your credit card one of the following amounts below:

Option 1 - $1000 - 6 page site (1 Enter page, 1 Home page, 1 Tour page, 1 About Me page, 1 Links/Friends page, 1 Members page.
(WEB DESIGN ADULT CONTENT NOT INCLUDED IN PACKAGE...STRICLY JUST YOUR
WEB CAM FEED OR FEEDS.)
$500 Down Payment

Option 2 - $2000 - 6 page site (1 Enter page, 1 Home page, 1 Tour page, 1 About Me page, 1 Links/Friends page, 1 Members page.
(WEB DESIGN ADULT INCLUDED IN PACKAGE... USEAGE OF OUR MEMBERS AREA.)
$1000 Down Payment

Accept Terms?

PAYMENT INFORMATION

Expiration Date:Month: Yr:
Card Number:
CDV Code:	* THE 3 DIGIT NUMBER ON BACK OF THE CARD.
Name as it appears on Credit Card: