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Website category
(ie wedding, birthday) |
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Design theme (ie
angels, pets) |
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Package (ie basic,
standard or luxury) |
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Where did you
hear about us? |
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Information about
you, the purchaser |
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Name |
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Address |
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Phone |
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Email |
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Information about
the recipient (the person the website is for) |
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Name |
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Address |
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Email |
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Gift certificates |
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If you
are giving this website as a gift, and would prefer the recipient(s) to supply
their own information, complete the box below. |
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Names to appear on
gift certificate
From:
To:
On the occasion of:
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We will
mail you a gift package, which will include a gift certificate, and a form
for them to complete, and give no indication of price. |
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Captions for each
numbered photograph |
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1
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2
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3
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4
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5
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6
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7
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8
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9
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10
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If you
are supplying more than 10 images, please list the remaining photo captions
on a separate sheet of paper.
Please read our terms and conditions about copyright images.
All material supplied to us will be returned in the post free of charge
to you, the purchaser.
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Other information
to appear on the website (names, dates of birth, marriage, death, birth
weight, etc.) |
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If you
are sending printed material such as newspaper clippings, marriage order
of service, obituary notices, etc., we suggest you make sure they are not
your only copies, just in case they are lost in the post. |
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Information about
the recipient's interests and hobbies for weblink pages |
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If there
are specific websites you would like featured, please give the URL.
If you are ordering the football website for a child, please tell us the
team they support so that we can customize the design. |
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If there is a
webring (ie Birthday Club, Mourning Light) that is appropriate for the website,
would you like ZyberZoom
©
to join in the recipient's name? |
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Yes
No |
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Date the website
should start |
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...............(day) /................(month) / .................(year) |
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We will
notify you, the purchaser, as soon as the website is ready. |
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Telling the recipient
about their website |
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Please
circle the method you prefer: |
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Purchaser to let them know
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ZyberZoom
© to
send email when the site is up
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ZyberZoom
© to
send email on specified date:
...............(day) /................(month) / .................(year)
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If you have any
queries, please do not hesitate to contact us before mailing this form.
If you do not hear from us within 1 week of mailing this form, please contact
us IMMEDIATELY, in case your order is delayed in the mail. |
