Grumpy's Web Graphics and Design

Grumpy's Web Design and Graphics Information Request Form

Please use the form below to email us for additional information. You can use the check boxes for information on any item listed or the comments box for any other questions.

Your name:
Company Name:
Company Address:
City, State, and Zip.
Your Telephone:	2nd Telephone:
Your Fax:	Your email address:
I am interested in a new WWW Site:	yes no
I am interested in updating my present site:	yes no
My site address is:
I would like information on:
Scanning	Video Clips
Sound Clips	Real Media™ Streaming sound or video
CGI Scripts	Data archiving to CD
Other, please specify:

Please use the box below for other any questions or comments you may have.

Be sure your return e-mail address is in the box for "Your Email Address" above.

Thank you for taking the time to talk to us.
Please push the Send button only once.