Web 360 Pix Imaging
PRINTABLE ORDER FORM

COMPLETE FORM AND FAX TO: 928-764-1481       Close Window
CUSTOMER INFORMATION:
PLEASE FILL IN ALL BOXES BELOW THAT PERTAIN TO YOUR NEEDS
Agents                                              
                                        First Name                                                                                Last Name                            
Company Name                                  
office Address:                                  
City:                   State:     Zip Code:        
office Phone: Cell /2nd Ph:
Agents Email                                  
Contact Name If
Different Tan Above:		 Phone
Number:

BILLING INFORMATION:
Credit Card Type (Please Check One)

Master Card:

  

  Visa Card:

  

American Express:

      
Card Number:                                  
Expiration Date: Month   Year   CVCC #         3 / 4Digit Code On Back / Front Of Card
Card Holders Name                                  
                                                                First Name                                                         Last Name                                     M.I.
Billing Address:                                
City:               State       Zip:          

Agents Signature For Ordering Authorization:__________________________________________________
 
Listing Information and Product Selection:
MLS Number:                                  
Property Address:                                
City:                 State:     Zip Code:          
Product Selection:
Home Tour 360 Virtual Tour Package includes  tour technology, processing &  distribution.
Put a Check in Box or Boxes That Applies To Your Needs
    Home Virtual Tour $89.95     8 Scenes  
    Home Virtual Tour $99.95     10 Scenes  
    Home Virtual Tour $119.95   12 Scenes  (New Special Offers...!)
 

X

 Deliver Tour to me and the following National Real Estate Websites
(Requires active listing on each site)
    Realtor.com (A)   Homes .com (B)   My Business Website  (C)
    4-5 Still Digital Photos $18.95     5-6 Still Digital Photos $28.95
    CD w/10 to 15 still digital photos,  custom cover mail direct to customer  $39.95 Includes postage
Business Website w w w.                          
Webmaster Email                                
Personal Website w w w.                          


f You Have Any Question Please Contact Customer Service at 928-764-1481
Email: support@web360pix.com                        Email Orders to: order@web360pix.cm
 
REQUIRED: If the above section is left blank, It will result in a delay in processing. I understand that there is a $20.00 charge if I order additional scenes above the allotted per tour. Re-Posting fees for changing MLS # or agent contact information is $9.95.Tours are valid for one year date purchased. 
Additional fees may apply to tours outside LHC service area
All rights reserved. Home Tour 360 and Homestore.com are registered trademarks of Homestore Inc.
All rights reserved. iPix and the iPix logo are trademarks and services marks of Internet Picture Corporation

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