Now that you have read our main page and you want us to Submit your URL for you, You will need to fill out this form below. Please make sure to print in clean clear BLOCK letters so that we can understand your information. PRINT THIS PAGE OUT AND MAIL IT WITH YOUR PAYMENT One time submittal $20.00 Two time submittal $30.00 Please make your payment out to --Roy Rudder-- and mail your payment to the following address. 4024 Bull Creek Rd. Nathalie, Va. 24577 Ph: 804-376-2542 Please take your time and fill out correctly, your information will be submitted based on the Information on this form. Check and then double check the URL before submitting. Site Details: URL: _______________________________________________ URL Title: _______________________________________________ Keywords: _______________________________________________ Web site description: ________________________________________ ______________________________________________________________ ______________________________________________________________ Put an X beside the one that Classifies your site Classification: Personal Homepage___ Commercial/Business___ Education___ NonProfit Organization___ Shopping Site___ Category: Automotive___ Business___ Computing___ Consumer Products___ Education___ Employment___ Entertainment___ Finance___ Internet___ Media___ Recreation___ Reference___ Services___ Science and Technology___ Travel___ Type: Advertising/Marketing___ Agriculture___ Communications___ Consultants___ General___ Import Export___ Industrial Goods___ Mail Order___ Office Equipment___ Opportunities___ Resources___ Stock Market___ Wholesale___ Post to Adult sites: Yes ___ No ____ With posting to adult sites you will get over 400 more submittals Contact Details Company Name: _______________________________________________ First Name: _______________________________________________ Last Name: _______________________________________________ Title: _______________________________________________ Email: _______________________________________________ Address: City: _______________________________________________ State: _______________________________________________ Zipcode: _______________________________________________ Country: _______________________________________________ Telephone: _______________________________________________ Fax: _______________________________________________ Toll Free: _______________________________________________ Where did you hear about us at? _______________________________ Any questions email: urlsubmit@rrudder.com