ORDER FORM

Please take time to read the 'Terms and Conditions of Sale' before completing the order form.

NOTE: IF YOU CHOOSE TO PAY BY CREDIT/DEBIT CARD YOU WILL BE TAKEN TO THE WORLDPAY SECURE PAYMENT CENTRE WHERE YOUR CARD DETAILS WILL BE TAKEN.

Your Details
Your name:	[required]
Business name:
Street address 1:	[required]
Street address 2:
Street address 3:
Town / city:	[required]
County:
Post code:	[required]
Home Telephone:
Work Telephone:
Mobile:
Fax:
E-mail:	[required]
Company Details
First choice of name:	Limited [required]
Second choice of name:	Limited
Your FREE Domain Name (Deluxe package only) If unsure of the choice of domain name at this stage or would like advice please leave blank and we will contact you.
www.	.co.uk.ltd.uk.plc.uk
Chosen Package
Choose your package:	Economy Standard Deluxe [required]
Payment Details
Pay by cheque	Please make your cheque payable to First Business Systems Limited and send it to the address below (Your order will be held until payment has cleared). £81.08 (£69 + VAT) for the Economy Package £116.33 (£99 + VAT) for the Standard Package £233.83 (£199 + VAT) for the Deluxe Package
Pay by telephone	Your order will be held until we call you to arrange payment.
Pay by debit or credit card	Please be ready to give your debit or credit card details.
General Instructions/Comments

How did you hear about us?
	I've used you before I was recommended by a friend I found you on a search engine Other

Terms and Conditions of Sale

Please note that once the documents have been lodged
with the registrar, the order cannot be cancelled.

First Business Systems Ltd
19 Forest Court
Barlborough
Chesterfield
S43 4UW

Chesterfield — Tel: 01246 811182 or Fax: 01246 570716

Doncaster — Tel: 01302 554988 or Fax: 01302 554996