Application for Web Service from The Private Investigators Mall (sm). Fields marked with a * are required.

$75 Special NAIS One Year or $125 if you are not in NAIS

Questions? Call 404-202-1799

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General Information

* First Name:  ">
* Last Name:   ">
* Company:  ">
* Address:  ">

* City:


* State:

* E-mail:  ">
* Company Phone:  ">-">-">
Company Fax:  ">-">-">
For Hosting (PIMall hosts your site as well as linking it)

 Provide the name you have ALREADY registered with Network Solutions or another website registrar

Website URL:  ">

 Do you need your website created?  

  checked <%End If%>>Yes checked <%End If%>>No

 If you need your website created, please select up to 5 email addresses to use

Email 1: ">
Email 2: ">
Email 3: ">
Email 4: ">
Email 5: ">
Do you want Anti-Spam protection turned on?   checked <%End If%>>Yes checked <%End If%>>No

 If you need your website hosted, and would like to have FTP access to your account, please provide
 us with an FTP account name
(for uploading your pages)

FTP Account Name Desired:  ">
For Links Only (Your site is already designed and hosted by another, you would like a link inside the PI Mall)
Website URL:  ">
E-mail Address:  ">
Section To Be In: checked <%End If%>> PI     checked <%End If%>> INFO-BROKER    checked <%End If%>> PI STORE 
Website Keywords

Keyword 1:


Keyword 2:


Keyword 3:


Keyword 4:


Keyword 5:

States You Are Licensed In

State 1:


State 2:


State 3:


State 4:


State 5:

Search Engine Optimization (rank higher in search engines)

Would you like to be contacted about improving your ranking in the major search engines?

checked <%End If%>>Yes checked <%End If%>>No
Contact Information
Phone Number:  ">-">-">
E-mail:  ">
NAIS Number:  ">  
PI Mall Mailing List

Do you wish to be added to the following mailing lists?

PI Mall Alerts: checked <%End If%>>Yes checked <%End If%>>No
PI Classroom: checked <%End If%>>Yes checked <%End If%>>No
NAIS Alerts/Updates: checked <%End If%>>Yes checked <%End If%>>No
Security Alerts: "1" Or Request("secalerts") = "Yes" Then %> checked <%End If%>>Yes checked <%End If%>>No

Email Address To Send Alerts To: