Enquiry Form
Name:
* E-mail:
please enter e-mail
Phone
Domain name
1st
choice:
2nd
choice:
3rd
choice:
Do you require hosting ?
Yes
No
part 2
what type of package do you Require
Complete
Basic
Just hosting
just site construction
hosting and site construction
E-commerce solution
Would you like us to make a free submition to 15 search engines for you?
Yes
No
Maybe
would you like Stickies to be added to your site ?
yes
no
maybe
What are stickies?
How did you Find out about us ?
Recommened by someone
TV or Radio
Newspaper
Via the Internet
Other
Would you like to received details about other promotions Netfaze might run?
Yes
No
Maybe
Not even if my life depended upon it
Only once every 6 months
Other Info