Order Form for your 4-month trial Invention Web Page:

To purchase your own Invention Web Page, which I will build for you as part of this 4-month trial offer, please fill out this page and either e-mail it or snail-mail it to me at the address listed below. To include pictures of your product, you can either mail them with this form, or send them by e-mail. The total cost is only $98.33.

Your web page will be on this site within 3 days of receiving your order. At the end of your 4 months, you have the option of extending your web page for a full year for 1 payment of $196.67, or you can let it expire.

Feel free to call me at (800) 337-5758 if you have any questions. Thanks!

Best Regards,

Paul Niemann

1.    Title of your invention: ________________________________

2.    Please describe your product. (You'll want to list the key features and benefits of your product, who your product is intended for, production costs, expected retail price and any test results or market research data that you've received, if any). Attach an additional sheet if necessary.

3.    What is the status of your invention? Please check one:

    ____ Patented (Patent Number = __________ )

4.     Name ____________________

        Address ____________________

        City, State, Zip ____________________

        Telephone ____________________

        E-mail (optional) ____________________

5.    Would you like to have your name, address and phone number included with your listing? (Some of our customers prefer not to have their personal information listed on the Internet. If you choose No, we will give your name and phone number only to those companies who call and request it.) Please check one:

    ____ No

6.    Signature _________________________________    Date ________________

Please send this form, along with your check or money order, to:

Market Launchers, Inc.
2614 South 24th Street
Quincy, IL 62301
niemann7@aol.com

Thank you!