DILIGENT NIGERIA 2nd Floor, Suite 3002, LISA COURT 1 Ilaka Street, Ilupeju Estate, P.O. BOX 3080 Marina, Lagos Website: www.diligentnigeria.com Email: email@example.com SPECIAL OFFER - SUBSIDISED WEBSITE DEVELOPMENT ( Registration Form ) TERMS AND CONDITIONS You must agree to the following terms and conditions before completing this form: 1. Your organisation is a Small to Medium sized enterprise employing less than 250 employees and has a turnover of less than two hundred and fifty million Naira. 2. You are responsible for the contents that will appear in the website. The website will not include any material which may be deemed to be offensive e.g. pornographic material. 3. You will supply the contents of the website in Microsoft Word format as soon as possible. 4. You agree to limit the contents of the website to 10 pages. 5. You agree to pay a fee of #19,995. This fee is due when this form is handed in. 6. The above fee is for one year only. 7. You agree that once the website goes live, any modifications will be charged at #1,000 per page while each new page added will cost #2,500. 8. You will supply three domain names. You agree that if your first name chosen is not available, Diligent Nigeria can register the second name chosen. If the second name chosen is not available, then you agree that Diligent Nigeria can register the third name chosen. 9. You will supply ALL of the email addresses you intend to use with your domain name at the time you complete this form. You agree to pay Diligent Nigeria a fee of #750 for every email address that is later added. 10. You agree that the website cannot be transferred to another domain without the written consent of Diligent Nigeria. Company Details Name: Address: Contact(s): Telephone(s) Email: Website Details Domain Name First Choice: (.com only ) Second Choice: Third Choice: Email Addresses ( Enter up to 25 email addresses) Deposit Paid Amount: Balance Due: Declaration I have read and agree to the terms and conditions of this offer. Name Signature Date A pilot project sponsored by the World Bank and Federal Government of Nigeria.