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Website Package Order Form
By Explosive Concepts, Inc. on January 31st, 2012
Contact Name
*
Company Name
Billing Address
*
City
*
State
*
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Email Address
*
Phone Number
*
URL to be associated with this Website
*
Do we need to register this domain Name?
*
No - I own it and will change the DNS settings to the Explosive Concepts Host DNS
Yes - This domain name is available, please get it for me and set it up
Do you have graphics we need (logo files, etc)?
No - We need help on this
Yes - I will provide you with some graphic files
Which Explosive Website Package do you want?
*
Starter Package - $499
Standard Package - $999
Premium Package - $1499
eCommerce Package - $1499
Another Package I contacted you about
What theme should we use from the package selected above (the name and number is located under the sample picture)
