Jan Veuger Internetdiensten

By filling out and submitting the form below, you enable us to take a closer look at your present facilities and your wishes, and so give you a proper advice whether one of our packages can suit your needs.

Fields marked with * are obligatory.

Information about applicant:

Organisational or personal name:

Address:

Zip code/place:

Country:

Contact person:

Phone number:

Email:
(existing email address)

Present facilities at my disposal:

Present domain(s):

Present website(s):

Present email address(es):

I am interested in the following facilities:

Website management with the Content Management Systeem 'QwikZite'

Website management with FTP access

Unlimited number email addresses incl. email manager/webmail

Only 1 email address incl. webmail

Mailing lists

If possible, I would like these facilities at:

My existing domain:

A new domain:

I wish to know whether my present website can be managed with the CMS QwikZite:

Retaining the following specific features:

Retaining the following sitestyle or specific parts of it:

Remarks:

In the box below you can express additional wishes.

Did you fill out everything?
We advise you first printing this form for your own convenience.
Subsequently, press the button below to submit your advice request.

Jan Veuger Internet Services - P: Postbus 2599, 4800 CN Breda, The Netherlands
T: +31-6-244 33 608 F: (+31)-84-830 77 66
E: info@janveuger.com - W: www.janveuger.com

Developed with QwikZite (version 1.12)