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InfoSheet Script Hosting Order Form

If you wish to have InfoSheet host the BFormMail CGI script on our server for your website, please complete the following information in the table below.

When you complete this form, you will be taken to our PayPal payment page.  If you want your account setup faster, please complete the payment for $75, or you may send a check or money order for $75 to cover setup plus the first year, made payable to:

The Byte Shop, 4201 Church Road, Suite 12B-185, Mount Laurel, NJ 08054

Your name:
Company name:
Phone:
Address, City, State, Zip:
your e-mail address:
Url for referer tag:
(refer to readme)
script recipient email address
(refer to readme)
Netmoves/faxsav permanent stamp:
(if a subscriber)
How did you find us?
Additional information/comments:
	 

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