I. Information
The URL:
Company Name:
Address:
City, State, Zip:
Phone:
Fax:
Toll Free:
Contact Name:
Contact Title:
Contact Phone:
Contact E-Mail:
II. Title of Page: (Maximum Number of Characters Recommended is 60)
III. Description: (Should include as many "Key Words" as possible - Maximum Number of Characters Recommended is 150)
IV. Keywords: (List these in order of importance - Maximum Number of Characters Recommended is 874)
V. Category: (what type of business are you?)
VI. Target Market: (i.e. senior citizens, families, children, etc.)

By signing, I give WebbSite, Inc.™ Permission to submit on the Internet, for the sole purpose of providing an advertising service, the Web page of the company whose name appears in Section 1. I confirm that I understand the charges for the top 12 Search Engine submissions to be exactly $90.00. As a representative of the company stated in Section 1, I certify that the said company understands the rates and services and agrees to pay for all services rendered by WebbSite, Inc.™ (Please note: the name entered below should match the contact name listed in section 1 of this form. By retyping the name, this is considered your digital signature and is legally binding.)