PIIAI
Member
Website Project
Template Development
Comlete this form if you have your own URL (web
address) already registered, AND have your website already
created.
I. Please provide
us with the URL for your agency.
II. Contact Information.
Additional E-mail boxes are $2 per box, per month, or choose
a 10-pak of e-mail boxes for $13.95 per month. PIIAI
templates come with one e-mail box, so please fill in the first
e-mail box. If none are desired, please leave blank, and select
"Please establish an account for monthly billing".
Please use the format of, "___________@myURL.com"
Charges less than $10 per month must be billed to a credit card.
Charges in excess of $10 can be billed. To set up credit
card billing, please print out, and fax the credit
card payment form.
For personal website design or special
alterations to your current website, please contact EOS, inc.
at (800) 241-6006 for consultation and estimates.