Url Sign-UP

HOW!
Simply fill in our URL Feedback Form Below including your Desired Payment Method
and we will get back to you soon with more information.

Your Profile
( private use only, will not use for marketing purposes )

* Business Name:

* Contact Name:

Phone Number :

* Type of Business:

Business Address:

* Postal Address:

* URL of Business

eg www.yourbusinessname.com

Categories:
Business to be submitted to i.e. Accommodation for hotels/motels websites

Choose 1 or more.

1) 2)

3) 4)

Other category not listed ( we will set up separate page free of charge)

Leave Blank if unsure, No extra charges for more than one category

Placement Time: Choose 1

For 1 year $20.00

For 3 years $55.00

For 5 years $87.00

My Website URL will be placed for in the Perth Business Directory.com

Payment Methods - choose 1

Types:

Pay Online: ( fastest )
A PayPal Link will be e-mailed to you after we receive your details

Pay by Direct bank depost:
Our BSB & Account number will be e-mailed to you we receive your details

Pay by Cheque:
Please make out the Cheque to 'Arakhne Web Design' who owns and maintains this website and post to

PO Box 193, Wundowie WA 6560

Please choose one Payment Plan:
With this URL submission, I choose the following payment Plan

NB: Tax Receipt will be e-mailed out to above responses when payment is made.

Authorization:

I (name) of (business) am authorized to sign

with Perth Business Website Directory.Com for the Amount and Period of time chosen above.

Dated

NB: URL will be taken down, if payment is NOT received within
6 weeks of submitting this Form.

NB: This Site maintained and designed by ArakhneWebDesign.com
ABN 76 897 723 842
( Where all payments are directed )

Joanne Smith B. A. Australia