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City, State, Zip *
EMail Address *
Web Site Address
Please include your country code on all phone numbers.
Desired background color?*
Desired Text Color?*
Will you need custom graphics or do you have your own logo?
How many pages will you be needing? Page = (8 1/2 X 11)
Would you like Java on your page?
Is there a page on the net that we can see that is similar to what you would like and if so what is the address (http://)
Please tell us anything else you might want on your page?
Contact me ASAP