SLG Web Design Service Agreement - Sign Up Form

You Are Agreeing To Have Read All SLG Web Design's Terms Of Service On Our Website.

First Name*

Last Name*

Business Name

Business EIN # or Social Security #*

Address*

Street AddressCityState / Province / RegionPostal / Zip Code

Telephone Number*

Area Code

Phone Number

Mobile Number

Area Code

Phone Number

E-mail:*

Fax Number

Coupon Code

Select a Service*

Web Design & Hosting Services ($12.99)

Restaurant Online Ordering System ($12.99)

Domain Name(s)

Additional Notes

You will be directed to PayPal's Secure Checkout.

Processing fee will be assessed upon checkout.

Required*

I Acknowledge & Confirm

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