Order Form

Order Form

Now that you have looked over our system and are ready to make your purchase, we need you to complete the form below. Please remember that fields marked with an asterik (*) are required fields. We have broken down the order form into sections for easier processing. You may find that as you answer a question a new section may appear for completion. Thanks for your order and a representative will be in touch with you shortly.

Primary Contact Information

	Contact Person:
	Phone Number:
	Email Address:	(xxx@yourcompany.com)

	Funeral Home Name:
	Physical Address:
	City:
	State:
	Zip Code:
	Do you own a Domain Name for your Funeral Home?	Yes No
	If yes, what is the Domain Name?	(www.yourcompanyname.com)
	If no, can you provide us with a domain name that we can look up for availability?	(.com or .ca)
	Does your Funeral Home have multiple locations including either same or different names or satellite offices?

Product Selection

Please select one of the following product selections:

FrontRunner Pro Web Site

$1695.00 one time fee

FrontRunner Web System

$1995.00 one time fee

FrontRunner Arranger System

$2995.00 one time fee

Projected Launch Date:

(mm/dd/yyyy)

Please select your design:

Designer Series (included) Please view your choices
Custom Design ($1295.00)

Custom Series Questionaire:

Please complete the following questions: (you may also download a offline copy, and fax to our office)

Logo: (please select one)

On file
I'll email it
Just typeset my firm's name in a display fashion

You can email your logo to marketing@frontrunnerpro.com.

Photography:

Portrait(s)
Exterior
Stock
None/Other (if other please provide a description below)

Business Profile:

Please mark as many descriptions that apply to your business and it's clientele.

Facilities:

(please the number of facilities that you have)

Location(s)

Rural Suburban Urban

Primary Business:

Burial Cremation

(If you would like to provide more information, please use field below:)

Do you consider your firm to be:

Traditional Contemporary

Do you consider your firm's architecture to be:

Traditional Contemporary

Is your firm ethnically or culturally influenced?

Yes No

Is your firm rich in history?

Yes No

Primary Artistic Direction

Are there any reference websites, or parts of websites you wish to influence us?

(List names of we've done, or addresses of one we haven't)

(web site #1)

(web site #2)

(web site #3)

Is there any design formats we need to avoid?

(Example - "My competition's site navy blue.")

Are there any colors or themes you'd like to stay consistent with?

Is there anything else you'd like to tell us?

Simply One Fee

Please select either the monthly or annual Simply One Fee:

Website Only

$49.95 / month or $599.40 annually

Web System

$69.95 / month or $839.40 annually

Arrangement System

$79.95 / month or $959.40 annually

Additional Services

Please check mark any services that you would like to have added to your order.

Content transfer from existing web site:	($149.95 for 15 web pages)
Transfer existing death records from existing web site:	($249.95)
Additional Domain Name(s):	($75.00 for 3 years)
Logo Creation:	($1995.00, includes stationery design)

The information below will serve as a reference, as well as improve the accuracy of initial designs. If you feel that answers to the questions below do not meet the specific criteria that you would like to see reflected in the design, please feel free to contact us.

Exact Copy Required

(Example: Smith Funeral Home & Cremation, LLC)

Business Profile

(Please mark as many descriptions that apply to your business and it's clientele)

Facilities:

(Please the number of facilities that you have)

Location(s)

Rural Suburban Urban

Primary Business:

Burial Cremation

(if you would like to provide more information, please use below field)

Do you consider your firm to be:

Traditional Contemporary

Do you consider your firm's architecture to be:

Traditional Contemporary

Is your firm ethnically or culturally influenced?

Yes No

Is your firm rich in history?

Yes No

Primary Artistic Direction

(complete only the applicable fields)

Is there any specific style or idea you had in mind?

Did you see a logo from our samples page that you liked?

(please name the company)

Or, would you rather leave the design open to recommendation?

Yes No

Is there any design formats you want us to avoid?

Is there a landmark, architectural feature, or unique object that you feel would translate well into representing your firm?

Is there any colors or themes you'd like to stay consistent with?

Is there anything else you'd like to tell us?

e-Commerce Module:

($249.95)

Order Conclusion
	We are requesting that you provide us a Username/Password that you would use to login to the administration system. Please remember that passwords should contain both numbers and letters to maximize the security.
	Requested Username:
	Requested Password:	(Security Note: A combination of letters and numbers is required)
	If you had a distributor partner representative contact you before your order, please provide their name below:
	WLSA Sales Rep:
	Milso Industries Sales Rep:
	To conclude your order, we need you to select your payment method for the One time setup fee, Simply One Fee and any additional services that you selected.
	Select Your Payment Method:	Credit Card (if you wish to pay by credit card, please complete and fax our Pre-Authorization Form) Company Check

By submitting your order, you have acknowledged that you have read and understand our terms and conditions agreement.