Mail to: Global Web Builders
P.O. Box 11
MT CROSBY NEWS 4306
Queensland

Business Name:.............................................................

Address:..............................................  Suburb:...................

State:.......................................       Postal Code:..............

Daytime Phone Number:.................................

PLEASE DETAIL THE FULL WEB LISTING NAME:

............................................................

PLEASE DETAIL CLEARLY WHICH CATEGORY YOU WISH THIS WEB TO BE LISTED UNDER:

............................................................
ADDITIONAL CATEGORIES AT $250 FOR THE YEAR (ATTACH SEPARATELY)

I confirm that I have enclosed:
First year payment for $ .........  (If credit card enter details below).
HTML File and Graphic  ......


                            PAYMENT DETAILS:
Please include our web as a high priority listing on your guide:


               Enclosed cheque or money order for:............
               or please debit my credit card:

Card No: ...........  ............  .............  ............   Expiry Date:...........

Name on card:....................................................

I understand that this payment gains me a high priority listing for 12 months
on the Definitive Lifestyle Guide to Australian Webs and that the editors 
reserve the right to refuse this application and to return my payment.


Signed:...........................

Position:...........................................