| * Required fields
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Contact Information |
| Name* |
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| Company* |
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| Business Industry Type*
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| Describe Your Business*
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| Phone* |
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| Fax |
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| Email* |
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| Preferred method of contact |
Phone Email |
| Current or proposed web site URL |
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| How did you hear about us?* |
Web search
Referral
Newspaper
Yellow Pages
Other |
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Project Goal |
Primary Goal *
What do you want the web site to do for you? |
Business Card Website
Sell Products
Sell Services
Demonstrate
Teach
Other |
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| Type |
Service Requirements
Description / Usage |
| New site design or re-design |
New website
Redesign old site |
Domain name registration (www.site.com)
Only $19.95 per year! |
Yes NoNot sure |
Hosting needed? (Where your site resides)
As low as $19.95 per month |
Yes NoNot sure |
| Search engine optimization & submission |
Yes NoNot sure |
Site maintenance
Would you like us to perform updates
to your site regularly? |
Yes NoNot sure |
| Company branding / logo creation |
Yes NoNot sure |
Photo & file scanning / photography
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Yes NoNot sure |
Specific features
Slide shows, flash animation, business forms, adobe pdf, guest book, video clips, audio clips, database, message board, etc |
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| Other |
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Site Architecture / Style |
Estimated number of pages
Home, about, services,
history, contact, etc
Flow chart & organization
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Color scheme / fonts:
Company colors , fonts, etc |
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Inspiration
URL's to web sites that are similar to what
you are looking for |
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Deadline |
| Projected start date* |
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| Projected deadline date* |
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| Additional comments |
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