Principal:
2nd
Principal:
3rd
Principal:
Address
of 1st Principal:
City:
State: Zip
Code:
Province:
Country:
Length
of time at this address::
Home
Phone Number:
Business
Phone Number:
Fax
Number:
E-Mail
Address:
Do
you own your own home?:
Present
Business or Employment:
Company:
Address:
Your
Position:
Company
Website Address:
May
we call you at your business if we are
discreet?:
How
did you learn of DomainZip?:
Do
you have cash or cash equivalents of $200K
or more?:
Do
you have substantial equity to pledge in the
event that you require a business loan from
a third party? NOTE:DomainZip may
provide financing to qualified individuals
with proper equity:
In
what E-Business are you interested?
1st
Choice Domain Name:
Starting
Bid:
2nd
Choice Domain Name:
Starting
Bid:
3rd
Choice Domain Name:
Starting
Bid:
Do
you have a specific purchase date desired?:
Please
detail your request:
Describe
your retail or business experience:
Describe
your internet experience, if any:
Please
list businesses recently owned:
