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ESECURITY4ALL
702/ 3-C, Vaishali Nagar,

Near Jacob Circle Post Office,
Mumbai, Maharashtra, India.
Pin Code - 400 011.
Email:
info@esecurity4all.com

Website: http://www.esecurity4all.com

 

        esecurity4all
Complete security for your CDs, DVDs, USBs & websites


                        Order Form (Website Protection)

Please Click here to read instructions before filling the order form.   Fields marked with (*) are compulsory

Please take a print out of this Order Form and send it to us after duly signing it along with the Cheque/ Demand Draft/ Money Order/ Postal Order/ Cash in favour of "esecurity4all" payable at Mumbai, India at the address given above. No application will be entertained without customerís signature.

Name of Contact Person *
Company
Designation of contact person
Address line 1 *
Address line 2
City *

  State*

Country *
Pin/ Zip Code *

 

Phone No.*

- - 

country code   city code            phone number
Email Address*

(Note: Rediffmail email accounts are not allowed. Please use   any other email account like yahoo, hotmail, indiatimes, etc)

Confirm E-mail Address *
Company's Website/ URL

How did you hear about us*

Order Details:

Qty. of Webpages to be protected*

Cost of Webpages Protection INR Rs.   or USD $
Total Payment to be made:

INR Rs. or USD $

(Shipping Charges extra (only  if you want protected webpages on CDs by post/ courier.)
(Please refer to the rate card given below for latest price.)

Payment Details: *

 

 

Payment Mode  Dated    No.

Bank name for cheque, DD/ Town Name for  MO    


 


Place:________________  Date: _________________                          Signature of Customer


Very Important: If you require partial protection for some webpages then please attach an additional page indicating the file name(s) and the protection features you want for each webpage. If we do not receive any special request then all the webpages will be protected with all the protection features.

 

Rate Card w.e.f.  March 1, 2009

 

1) Protected Webpage -  INR Rs.150/- or USD $3 per Webpage

 

2) Shipping Charges extra (only  if you want protected webpages on CDs by post/ courier.)

 

3) Shipping Charges are excluded if protected webpages are sent by email.

 

4) For bulk order pricing details contact us at info@esecurity4all.com

 

Note: Please select all payments in one currency only.

 


  


Note: This form is designed for A4 size paper settings. Please make sure that your Page settings are set to A4 size. By pressing the print button you will generate a printed form. Entire form above the Rate Card will be printed on a regular A4 paper. If your browser does not support the printing button function for this page, then simply use the Print Option under the File Menu at the top of your browser after you enter all your personal and payment details in the form.