|| GrafxEmporium || WebSets Request Form ||

:::::WebSets Templates Request Form:::::

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Enter your details below: (* Indicates required fields.)
Please review our full Privacy Policy.

* Site Name

* Site Url Address

* E-M@il Address: [Non Web-Based]

* First and Last Name: [Real]

• City/Country of Origin

* Web Host Provider: [Web Space]

• Select the WebSet Name below from the drop down list menu;
• Only ONE WebSet grafx request will be granted per unique site address;
• Mouseover .html javascripts & page layout included in zipfiles.

• Select a WebSet Template Name

• Select a 'Pro Series' WebSet Template Name

* Select 1 License Option from the 5 options

Yes No

* Is customization required for your webset?

• Please enter a brief site description, Feel free to leave or ask any questions that you may have.

Age Verification: If you are under 13 years of age, a legal guardian is required to e-mail or fax their consent & signature in addition to this request form.*

Select Yes or No agreeing to Grafx Emporium's Terms of Use & Service Terms.*

• Click the SUBMIT button only ONE time.
• Click the RESET button to reset the form to blank fields.
• Failure to submit ALL required * field entries will disqualify your grafx request.

If your browser does not support forms, you may send your request via E-mail Please provide ALL of the above information in your request. Payment information [if applicable] will be e-mailed to you. Keeping your personal information private is vitally important to us. As with all personal information, GrafxEmporium will never rent, sell or disclose your personal information. Please review our full Privacy Policy.

By submitting this electronic form you are acknowledging your agreement to our Terms of Use and attesting to the accuracy of the information contained within your submission. If any terms or policies are found to be violated or false statements made in your application or site after receipt of any of our files, we reserve the right to retrieve our graphics and a 72 hour window of opportunity is granted for you to remove our content from your site/s. Non compliance will immediately result in serious legal repercussions. Any bounced files will be denied & disqualified from future submissions.

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