If you would like to learn more about our Internet strategies for business or
if you would like to receive a free no obligation consultation, please fill out this short form!
Your Name___________
Company ____________
Type of Business____
Mailing Address_____
City________________
State_______________ ZIP
Telephone number____
Email address_______
Please include a list of objectives you would like your Web site to accomplish:
I would like the following:
a no obligation phone call about EZ New Media Internet Services
an information packet by mail
additional information via email (please be very specific)
none of the above
I am contacting you because:
We need a new Web Site for our business NOW! We will need a new Web Site within the next three months.
We want information about EZ New Media to keep on file.
none of the above
I am also interested in your Web Site Maintenance Plans:
Yes: I am interested in learning more about EZ New Media Web Site Maintenance
No: I am not interested at this time
Please include any comments or specific questions you would like answered:
