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	Site Development services: I would like IVD to build a single web page. I would like IVD to build a complete site. Page development is not needed at this time.
I would like to have a CRM set up (current promo: $175 setup, $35/mo) CRM service costs will appear on your next billing statement after the CRM has been provided.

Domain Services:
I manage my own domain or it is managed by a third party.
I want IVD to host my domain name ($14.95/yr)
I will use the MyInVenia domain (no charge - hosting required)
Check for domain availability

Site Hosting Services:
None, I will use my current host. Host name:

*If you do not know your host name or are not registered we will walk you through the process or "do it" for you.

Standard web site hosting for only $9.95/mo. ($99.95/yr. if paid in advance)
MyInVenia web page hosting for only $4.95/mo. ($49.95/yr. if paid in advance)
MS Windows ASP base web site for only $14.95/mo. ($149.95/yr. if paid in advance)

I am interested in other services (solely or in addition to the above)

Contact Info (The fields below with an asterisk are required so we may process your request):

First Name*:	Last Name*:
Bus. Name:
Phone*:	I prefer to be contacted by phone:
eMail*:	I prefer to be contacted by eMail:
Street:
City:	State: Zip:

Payment options and balance calculator:
Would you like to pay Monthly, Quarterly, Yearly
Your monthly recurring fee will be $0.00 Your fixed start-up fees are $0.00

Your approximate* balance based on your selections is: $0.00

*Your balance is NOT DUE at this time.
Discounts and other fees may apply after we have discussed your requirements with you.