Your Own Web Page for R40 per Month. Phone 082 783 2796

Application Form for your own Web Domain

Click here to apply for your Own Web Page at R40 pm

Print this form and complete:

Application Form Top:

1. Tell us about your Business

2. Your contact information

Application Form - Web Site (Domain)

Also have a look on our website for Your “WEB PAGE for R40 pm”. This is for your own Web Page linked via Smalladds.com.

Customer Tracking No____________________________2003 (to be filled in by Smalladds.com)

Application for your own own web domain. This will provide your own unique domain name and web site.

These forms must be filled in and faxed or posted back to: (Please keep a copy for your records)

Buckssa

Po Box 23738

Gezina

Pretoria

0084

Fax No.: 012 331-2440

1.0 Tell us a bit about your business. This information is required to design your new web site. Top

_{____________________________________________________________________________________________________}

1.1 Company / Business Name: ___________________________________________________________

1.2 What is your domain name? If you do not have one, we can search the Internet and help find and register one for you.

_______________________________________________________________________________________

1.3 List the Services or Products. Provide a short, powerful description, which will tell your customers what you have to offer. Use a separate page if required.

_______________________________________________________________________________________

1.4 Name or describe any specific issues you would like special focus on. This will then be displayed as a moving text banner, or just enlarged text. At additional cost, moving animation words, photos or slides can be designed to really draw attention to a specific topic. Please ask about this.

_______________________________________________________________________________________

1.5 Any other item, product or service, which needs special emphasis, please describe below. Please list any specific requests, or some ideas you might have about the page layout.

_______________________________________________________________________________________

2.0 Contact Information. This will be displayed on your web page. Top

2.1 Contact person / Consultant / Representative / Sales Manager / etc:

Name:__________________________________________________________________________________

Telephone Number Office:__________________________________________________________________

Telephone Number Home:__________________________________________________________________

Cell phone Number:_______________________________________________________________________

Street address:___________________________________________________________________________

Postal Code:_____________________________________________________________________________

Postal Address:___________________________________________________________________________

Postal Code:_____________________________________________________________________________

E-mail Addresses:_{_____________________________________________________________________________________}

_{_______________________________________________________________________________________________________}

_{Please
enquire about the option of your own e-mail addresses for your web site.
This would typically be the following, or what you would like it to
be.}

Examples:

_{info@domainname.com}

sales@domainname.com

yourname@domainame.com

etc.

_{We
will set up the accounts on our server, and you will do the same on your
e-mail program on your PC. The number of e-mail names can vary between
three and ten, depending on the package option.}

3.0 General Rules Top

3.2 Your Web Site will normally consist of a Main or Index page, linked to your product page, Frequently Asked Questions, and Contact Information. You can have a maximum of 5 linked pages for the standard tariff. No additional costs (Hyperlinks) to other sites will be charged. This is part of the set-up fee per page. See below for tariffs.

3.3 Changes to your web site/pages are accepted, at a fee. This depends on the frequency of updating information, and/or the complexity of any change or update. See below for tariffs.

3.4 Although Smalladds.com has taken all possible precaution to have this site up and running on a 24 hour basis, 7 days a week basis, the owners will not accept any responsibility for loss of data, information or advertising time in the event of a failure of our server, any ISP (Internet Service Provider), or the telecommunication lines.

3.5 Your web site will be linked to our Smalladds.com advertising site at no extra cost.

3.6 Referrals: An important incentive to take note of is the following: If you (as a subscriber) can refer ten businesses/persons to subscribe to our smalladds.com site, and they actually sign the contract and arrange for debit order payment, your monthly subscription will be free from then onwards! This will exclude any additional advertising costs / or changes to web pages.

3.7 Note that you will be billed annually for the renewal cost of your domain name, which will between R150 to R300 per annum, depending on the type of domain (e.g. .com or .co.za)

4.0 Tariff Structure: Top

4.1 Refer to the WEB HOSTING page for tariffs: WEB HOSTING

4.2 Advertising: As part of our service, your web site will be posted on the South African and International Search engines where this option is free. You are free to do your own advertising or promotion as you see fit.

4.3 We can digitise your existing photos to be used on your web site, at no cost (maximum 6). We can also take digital photos of your shop, products, services, staff, vehicles, etc. to be displayed on your web site. No cost, but we charge R3.00 per km transport from our offices.

5.0 Agreement: Top

I hereby understand and accept the above terms and conditions.

Name:________________________________________________________________

Position:_______________________________________________________________

Signature:______________________________________________________________

Date:__________________________________________________________________

Telephone No.: __________________________________________________________

Service Quoted: (In SA Rand) inclusive of VAT

Web Domain Registration:____________________________________________________

Web Site Design:___________________________________________________________

Web Hosting:______________________________________________________________

Other:____________________________________________________________________

The above as per detailed quotation from the Webmaster at Smalladds.com

ABSA Bank

Debit Order Procedure

In order for Smalladds.com to process your application for your own Web Site, you need to arrange for a debit order between you (the customer’s) bank account, and the bank account of Smalladds.com.

Visit any branch of ABSA Bank, and request the following at the INFORMATION COUNTER:

I would like to arrange a debit order between my (customers) account number 1,2,3, on a monthly basis into the following bank account number:

ABSA Bank

Branch: Ben Swartstreet, Pretoria

Branch Code: 334645

Account Type: Cheque Account

Account Name: Buckssa

Account Number: 4056 3463 45

WEB Site design and other options: Provide details and total cost as per quotation from Smalladds.com.

Provide all your particulars to the ABSA person.

Request a copy of the print out from the ABSA Bank representative and fax or post proof to:

Louis Calitz

Fax No.: 012 331-2440

Smalladds.com

PO Box 23738

Gezina

Pretoria

0084

You can also follow this up, or communicate back to us on info@smalladds.com or telephone 082 5644 106, or via our contact page.

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