TOT-21 Semi-Custom Web Site
                                                   
(Fax:  832-218-2380)
  
 FROM:   _________________________________

 RE:         _________________________________

 DATE:    ___________            PAGE:   __  of  ___ 
 


Organization Name (if any
):  _________________________
 
Contact Information:   ___________________________________
  
(include Method & Address / Number & Best Time - if reply is requested)
 
I Wish to Have a Quote on a Semi-Custom Logo, as Follows:
 
T-21 Design Number  (at top of Design Samples):   ________
 
Any Desired Changes to Basic Design:   _____________________
 
________________________________________________________
 
________________________________________________________
 
________________________________________________________
 
________________________________________________________
 
________________________________________________________
 
________________________________________________________

 
Will T-21 Provide a fully 'Custom Graphic Logo'
(y/n):   ________
  (Note:  a Standard Text Logo is Free)
 
Pictures in Web Site:
  # You Supply  ____  /  # From T-21  _____
 
Custom Maps Needed from T-21:
  # ________
 
Will T-21 Obtain an Internet Domain Name for You (y/n) ______
 
Will T-21 Publish the Web Site to the Internet for You (y/n): ____
 
Will T-21 to Monitor the Web Site for Operability (y/n) ________
 
Other Comments / Questions:   ____________________________
 
________________________________________________________
 
________________________________________________________
 
________________________________________________________
 
________________________________________________________
 
________________________________________________________
 
________________________________________________________
              Copyright T-21.com, 2008