Colchis Check Order Form

To place an order for Colchis Web Design or Webhosting services using your personal or business check please complete the Order Form below. If you do not already have a domain name, you can obtain a domain name now by going the the Colchis Domain Name webpage.

Full Name:	(Required)
Company:	(Optional)
Address:	(Required)
City:	(Required)
State:	(Required)
Zip/Postal Code:	(Required)
Telephone:	-- (Optional)	Fax:	-- (Optional)
Service:	*(Required )**
Order Total Amt:	US$.00 (Enter Total Amount for Order)
Bank Name:
email:
Website URL:
Website Title:
Comments:
Colchis Awards	If you want your website to be considered for one of the Colchis Awards, select the "YES" response.
Payment Information	Checks are to be made to the Order of: Charles C Caro Send Payment to: Charles C Caro PO Box 25593 Tampa, FL 33622-5593 USA Your order will not be accepted payment has been received by Colchis. If you wish to send your check or money to Colchis more quickly than First Class Mail, you may deduct $3.20 when sending initial payment by Priority Mail (up to 2lbs) or you may deduct $11.75 when sending initial payment by Express Mail (up to 8oz) when mailing from within the United States. For webhosting subsequent payments be received by Colchis one week prior to expiration date of current webhosting service term.

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