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Thank you for your request. Please print
out and complete the Change Request Form
below. Sign and fax form to 770-603-9177
First Name: ___________________ Last Name: _____________________________
Business Name: _______________________________
Address: _____________________ City: ____________________ State: __ Zip: ______
Phone: _______________ Fax: ______________ Other: ________________
Email Address: _____________________________________
Website Address: _________________________________________
In order to make the HTML changes we will need your user name and password
(No one can make changes to the site
without this information)
User Name: ___________________
Password: ____________________
I authorize Korrect Technology, Inc. to access my website and make
changes or
upgrades to the above listed website.
__________________________________________ Date:
___________________
Signature of Owner or Authorized Gatekeeper
for the above listed Website
Please don't hesitate to call us @ 770-603-0905 if you have any questions.
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