eaW Limited 'BE SAFE' Website Support Package ORDER FORM

1

Full Name Please fill in the full name of the decision maker of the company.

First Name

Last Name

2

Company NamePlease fill in the full name of your company.

3

Please type in your website URL to be protectedPlease fill in the website below.

4

EmailPlease fill in your company email address.

example@example.com

5

eaW Limited 'BE SAFE' Website Support PackagesPlease select the package required.

MONTHLY 'BE SAFE' PACKAGE at £39.00 plus vat per month

WEEKLY 'BE SAFE' PACKAGE at £63.00 plus vat per month

6

I am aware my chosen Support Package will commence on the 15th of the current month and be active for 12 months. Please confirm you understand the commencement date.

YESNO

7

I am aware that eaW Limited will invoice me on a quarterly recurring basis and payment is immediate to ensure support is upheld.Please confirm you understand the payment details.

YESNO

8

SignaturePlease sign and submit to confirm your order.

Clear

9

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