Blue Mint Media Corporation - Special Offer Order Form

* indicates a required field
First Name: *
Last Name: *
Address 1: *
Address 2:
Address 3:
City/Town: *
State/Province: *
Zip/Postal Code: *
Country: *
Phone: *
	Country Area Phone Code Code Number
Mobile:
	Country Provider Phone Code Code Number
E-Mail: *
Alternate E-Mail:
Password: *
Confirm Password: *
	(Password atleast 6 characters long)
Where did you hear about BM2C:
Please Specify:

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Briefly tell us what your company does: *	Briefly describe your target audience: *

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Logo Details

You want to have: *

If you know a logo that you like, please provide the exact web address below:

Choose your logo style: *

Please pick a feel for your logo (check all that apply): *

High Tech	Industrial
Contemporary	Artsy
Antique	Medical
Formal/Corporate	Kids
Casual	Other (please specify below)

How many colors should your logo have: *

Maximum 1	Maximum 2
Maximum 3	Maximum 4
Unlimited Colors (used for the "Illustration Style" logo)

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Corporate Identity Details

Desired Address: *

Number of Card Holders: *

Letterhead/Biz-card Contact Details: *

List Names and Titles of Card Holders: *

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Website Details

If you are interested in using our services for an already existing web site, please provide the URL for your site:

Please describe the nature of the web site you'd like our help with
(in simple terms- e.g., purpose, size, audience, etc.): *

Types of Pages to include in your website. * (Max 5)

Main Page (Home Page)	Splash intro page
Photo Gallery	Links Page
About Us	News Page

Extras to include on your site: (OPTIONAL - please note adding these features will increase cost)

Create a Flash animation for your Splash intro page
Include streaming video(s) on your site
Prepare an audio welcome message from you to your visitors
Create an online shopping cart instead of an order form
Include a password-protected private or members-only area on your site

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Tell us your company colors or desired colors: *

Any special font requirements:

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Preferred Date:
Please Select:

File Attachment

Any other information:

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Contact Us:
Blue Mint Media Corporation
T: +44 207 871 4416
F: +44 871 992 2622
Web: www.bm2c.co.uk
Email: sales@bm2c.co.uk