Universal Online Services

PRINTABLE ORDER FORM

Fax To Us Toll Free 24 hrs/7days For
Immediate Ad Placement:
1-800-458-0879 or 1-989-496-2551
(WE HAVE HAD THE SAME LOCAL PHONE NUMBER FOR OVER TEN YEARS!)

Or Mail to:

UNIVERSAL ONLINE SERVICES, Pixel Ad Dept.,
PO BOX 2440, MIDLAND, MI 48641-2440

(WE HAVE BEEN DOING BUSINESS AT THIS ADDRESS FOR OVER TEN YEARS)

All Major Credit Cards accepted as payment for your ISP License

I understand if all available space has been sold on the BILLION DOLLAR HOME PAGE you will
not bill my credit card and will notify me of this via U.S. Mail.

Enclosed is my payment for the size ad checked below (sizes are shown in pixels):
___400 X 50 - $2,000.00 (ONLY $972.00 (or $99 per month) if ordered on or before AUGUST 5, 2006)
___200 X 50 - $1,000.00
___100 X 100 - $1,000.0
___80 X 80 - $640.00
___100 X 30 - $300.00
___50 X 50 - $250.00
___30 X 70 - $210.00

Name: ___________________________________________________

Address: _______________________________________________________________________________________

Address (cont.) __________________________________________________________________________________

City/St/Zip ______________________________________________________________________________________

Daytime Phone _________________________________

E-Mail Address (if any) ____________________________

___ I have read and agree to the terms of service CLICK HERE FOR TOS

Credit Card Type __________________________________________________________

Credit Card Number ________________________________________________________

Exp. Date __________________________

Your Signature _________________________________________

Today's Date _______________________

Please be sure to include your ad copy with your order or we will contact you once payment is received.