Mail to:
@ctiveWEB NZ Ltd
18 Lichen Lane
RD1, Russell		  
Ph: (09) 403 8119
Fax: (09) 403 8118
E-Mail: sales@activeWEB.co.nz
Customer No:
Virtual Domain Service Order

CUSTOMER INFORMATION
Company or Name
Billing Address
Town
Contact Name (if company)
Phone
Mobile
Fax
E-mail

SERVICE INFORMATION
Domain name registration yearly $40 set-up fee $20
Domain name
Hosting:   quarterly yearly set-up fee
50 MB of disk space
$75 $275 $30
100 MB of disk space
$105 $385 $30
250 MB of disk space
$145 $539 $30
Please tick if paying quarterly or yearly.     Prices do not include GST.
Web Page Design
design concept $450 Design concept charge includes two hours consultation, the design of the 'look and feel' of your website and the design and layout of the home page. Special consideration is given regarding how Internet Search Engines (the main source of traffic to your Web Site) log the information on your pages. This ensures your pages will be displayed high on the list of search results.
subsequent pages  $100
page with form $200


AGREEMENT
I, the undersigned, hereby:
  1. Authorise @ctive WEB NZ Ltd. to design a web site on my behalf using material supplied for this purpose.
    The copyright © of all digital images and electronically published material stays with me.
    The web site is to be hosted as a virtual domain with the name specified as above.
  2. Agree to the Terms and Conditions outlined on ActiveWEB NZ Ltd.'s web site (http://activeWEB.co.nz/hosting/terms.htm).
Authorised Signiture
Printed Name
   Date