Print/Order Form
To order, complete this form,
print
, then Fax, or Mail (with payment)
to your local dealer.
Also you may either mail or e-mail to address at bottom of the page.
Purchase Options
Choose products and a payment method.
* Note:
On your own ISP website. You can add pages or make changes at will.
Hosting
If we are hosting your website on our servers for free, we charge for changes
$10 text, $15 Pictures
Local dealer will contact you for additional information if needed
Advertising:
See it on any
TV or Computer
tiDirectory
Three listings: 1) Display
ad
2) opt.
Internet Specials ad
. 3) opt.
BINGO
tiBus/Pro
Full 3 page ad: 1) front, 2) second 3) order form page. (add pages at will)
tiCombo
(both products) Make changes
on your website
any time. (see hosting *)
tiSecure Form
(clients can submit credit card info.
to you
with higher level of security)
Three (3) Months Prepaid $44.95
ea. ($29.95 + one time setup $15.00)
One (1) Year Prepaid
$69.95 ea.
(0 setup
)
Combo Three (3) Months Prepaid $89.90
($59.90 + 30.00 setup)
Combo One (1) Year Prepaid
$119.90 special
(0 setup
)
tiSecure Form, one (1) Year Prepaid $44.95
($29.95 year +
$15.00 one time setup
)
Free listing
(limited space available)
Dlr ID if known
Town builder phone, if known
Customer Information
Your entry must match the name and address on your credit card, or your bank may decline the offer. All information is kept confidential unless you tell us otherwise. Your telephone or fax number helps us contact you for technical and billing questions.
Your Email Address
FIRST NAME
LAST NAME
Write your internet special here
Write your FREE bingo prize here
BUSINESS OR ORGANIZATION
STREET ADDRESS
CITY
STATE
ZIP/POSTAL
TELEPHONE
FAX
Email address (i.e., yourname@xyz.com, no Web sites)
Yes, I want to receive upgrades at no charge
.
Payment Information
All of your payment information is kept strictly confidential
AMEX press | Visa
Master Card
Discover
CARD NUMBER:
Expire
YOUR SIGNATURE:
______________________________________________
Check or Money Order:
Make checks and money orders payable to
tipages.com
, drawn from a U.S. bank or from an international bank with funds specified explicitly as U.S. dollars. Please send this completed form with your order. For
faster service Mail or fax this order to your local dealer
.
Print & Fax
361/668-0036
or Mail with payment to:
tipages.com
Regional office
427 So. Reynolds St.
Alice, Texas 78332
If you prefer you can email this form here
this is a secured site. Just press submit
.
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