Web Page Design Information Order Form - Barya Lang Web Page Design

ORDER FORM Barya Lang Web Page Design of the Philippines Web Page Design Information Sheet This form designed by Doolittle School Affiliated with Doolittle Philanthropy. PO Box 257, Q Plaza Post Office Cainta 1900, Rizal, Philippines. Text/Cell: +(63) 919 308 2934 Land Line: +(63 2) 948-1581 Email: sales@baryalang.com
	Donna and Erik Web Page Programmers

Please complete the fields that would apply to your business. Our web site programmers will use this data to create your web page. Do not include information that you would not want the public to see.

If you have a business card, handouts, brochure, or any other information please feel free to forward it by land based postal service to our Post Office box shown above (but complete this form now so we have the additional information when your "paper" mail arrives in Cainta, Rizal, Philippines). Any materials you can provide will make your web page a better one for you when clients and potential new customers read and view your Internet web page.

NOTE:
Your order will not be complete (and sent to us) until you click the
"SEND" button
on the bottom of this web page order form!

*(Leave any fields blank that you do not want to display on the Internet)*
Full Business Name:
Owners Name(s):
Other Employee(s):
Land Line Number(s):
FAX Line Number(s):
Text/Cell Number(s):
Business Address:
Email address:
Year business began:
Your favorite color(s):

Please select a category that describes your business.

Please select the country you are ordering from.

What size of web page do you want?
(Click one of the little circles on the left.)

Barya Lang Fully Loaded

1,500 Peso Lang includes 1 year .com registration! Lots of text, 4 graphics

$26 (USD)

Barya Lang Standard

900 Peso Lang! Lots of text, 4 graphics

$19 (USD)

Barya Buy Sell

300 Peso Lang! Cheap, low cost, no graphics

$ 6 (USD)

Listing Lang

50 Peso Lang! a link from our site to your web page

$ 1 (USD)

(In the Philippines "barya" means coins, loose change, a money amount so small it does not matter.
The word "lang" is used for the English words "only" or "just" meaning a small amount of something.)

Check the method (below) that you use when you make your payment.
We will try to connect your order with your payment.
We need your payment to begin to build your custom web page.
If you believe you may qualify for a "FREE" Web Page tell us why you should qualify in the "Additional Information" box at the bottom of this order form and we will give your request / application our personal attention. Look at the HELP information about the FREE option.
Our web page designers need real businesses to build their "World Class" portfolios.

How would you prefer to pay for your new web page?
Click on the small box in front of the payment method to check it. A Second click will un-check it.
Click on the "More Info" to see help page of what the payment method is all about. Then click the BACK button to return here.

SMART Money
"More Info"

BPI Family Bank
"More Info"

Credit Card or eCheck
"More Info"

Money Order
"More Info"

Business Check
"More Info"

SMART Center
"More Info"

PayPal
"More Info"

Personal Check
"More Info"

CASH
"More Info"

OTHER
"More Info"

FREE
"More Info"

Please list the Services and/or Products you offer:

Important For Professionals: You should include your educational background, advanced study, or degree(s)
College, University, or other school name	Date Completed	Degree received


If you need additional room please include the information in the "Additional Information" box at the bottom of the form.

After you have submitted this form, and made your payment wait approximately 2 weeks.
Then go to Internet Barya Lang web page. Check to see what your new web page address is by clicking on your name listed on that page in one or more of the three categories (Pending, Payment Due, or Payment Past Due). When you are looking at your new Internet Web Page, your Internet address will be shown in the top of your browser window (similar to): " http://www.1cbt.com/your_web_page "

www.baryalang.com

CLICK "SEND" to SUBMIT your Order
> > > > < < < <

If you have any Additional Information add it here:

Caution: if you click "Clear the form" all information in the whole order form will be erased and you will have to re-enter it.

	Normal Non-Philippine rates for this web page is $250. If you use this Electronic Order Form and pay by an electronic means (Credit Card via PayPal or PayPal account transfer) you may order for only $6.00 (USD) using International PayPal account.
© Copyright 2004 - 2005 by Barya Lang Web Page Design, all rights reserved.