The password is for my use only so that when you want to make changes to your site, I know it is
you. Write the password down now (you will not see it again). If you forget your password,
send your account name and e-mail to me from my
contact page , and I will e-mail your password.
Password:
This section is for how you want the page to be set up.
Would you like your name to appear in the copyright at the bottom of the page?
Yes
No
If I find spelling or grammar errors in your text, would you like me to correct them?
Yes
No
If the photo you send is wider than the page, do you want me to resize it or let it carry over
(requiring left to right site movement)?
Resize if needed
Do not alter the photo
This section is for the information that will actually appear on your site. All of the inputs are
optional. If you do not want any of them on the page, leave that entry blank.
Site Title (example, The Perfect Pond Store (does not exist)):
After I receive your request, I will tell you where to send a photo for your page.
Caption (if desired) for the photo:
Location of the Store:
Store Address:
Store Phone Number:
E-mail for the Store:
Web site for the Store (if there is another one):
This store sells/does (you can check multiple choices):
Sells watergarden dry good
supplies
Sells liners
Sells pumps and filters
Sells pond ornaments and garden
decorations
Sells pond fish
Sells pond snails
Sells other pond animals
Sells pond plants
Builds/designs ponds
Repairs/cleans/maintains ponds
Other services
Text Box (type in whatever you want, limited to 1000 letters; no coding please, just straight
text, explain what services your company provides and/or what it sells):
This plan requires a payment of $10 before I will put up your site. To send payment, go to the payment page . You can do that now by clicking on
this link to open in another window, or you can do that after finishing this form (that page will
prompt you to go to the payment page, if appropriate).
I understand that my site will not go on-line until payment has been received:
Yes
No
I agree to the Rules and Conditions :
Yes
No
Last Updated: 6/8/09.