Web Page Order Form

Please Print this Page before you Press the Submit Button.

Sign up to have us design and post a web page for you.
 Our average time to get a new web page up is about 2 business days from when we receive your payment.  We have established a secure account, and we are now accepting personal and company checks for payment.  To expedite the setting up of your web page you may fax us a copy of your check as outlined at the bottom of this form.  When we receive your fax we will begin building your web page, and place it live on our system for your review.  If we have not received the check within 5 business days, your web page will be taken offline until we receive payment.   For your convenience, we will send you an invoice every month for payment, or you can have us just debit your account each month.  If you wish, you may also pay for an entire years worth of service for $300 with one check and we will waive your $25 set up fee.  If you plan to have a specials page added to your site, please make the check out for $400, as we will give you 2 months for free( $120 - $20).

What is your name?
What is your company name?
How did you find us on the Web?
Please pick an extension for your web address such as http://loanassist.com/loan/companyname  do not use caps, or special characters.  Remember, the longer the name, the harder it is to remember. http://LoanAssist.com/loan/
What telephone number do you want borrowers to contact you at?
Please enter your billing address
If you are a net branch, please indicate the manager of the parent net branch company with a name and Tel. number.  Thanks
Do you want to add a company specials section for an extra $10 per month?   This page is updated monthly.
How do you want your e-mail forwarded? I have an e-mail address
Please send to my fax for $1 per fax billed monthly.
What is your Fax number?
Please enter 3 paragraphs about your company that we can use to build your company information page.  Try to include positive things about your company such as how long you have been in business, industry associations, and any other positive things you would like prospective borrowers to see.  If you don't have enough info to fill 3 paragraphs we can provide some generic information about all mortgage brokers that should fill in the space.
Enter any info you would like put on your company information page.  This page is a separate page from your home page that gives specific information about your company, and services.  If you prefer to leave this blank, we will just reuse info from the preceding section.
Any Comments for us?  Please indicate if you plan to pay month to month, or 1 year in advance with our discounts.
To get started, simply print this page, and click the submit button.  We will e-mail or fax you a reply to let you know that we have received your information.  Then fax us a check for $50 ($25 set up fee plus your first months charges of $25) to our secure fax line 877-833-6285.   If you have signed up to have the optional specials page, please send us $60 and include up to 10 typed lines of specials that you would like to advertise.     Checks should be made out to LoanAssist.com, LLC, and faxed or mailed to 5035 South Youngfield Court, Morrison, CO 80465.   Our telephone number is (303) 972-3255, and Peter Temple will be working on your web page so ask for him.  

Print this Page prior to pressing the submit button.    By pressing the submit button you acknowledge the following:  I am employing LoanAssist.com for the purpose of providing my company with a subsection of their web page.  I understand that there is no guarantee that I will receive more or less business as a result of owning a web page.  Putting up a web site is only the very beginning of doing business online, and in to obtain internet business, I will need to advertise my web site.  LoanAssist.com is providing me with the tools to have a presence on the internet and it is up to me to promote my site to prospective borrowers.