Custom Web Design Form
Thank you for considering us for your project!

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Instructions:

• Fill out the form and click "submit"
• View the Terms of Service!
• Someone will contact you within 2 business days.

Name:
Email Address:
What are your web requirements?	Custom Web Design Starter Web Design Website Makeover Selling a Website Web page Changes / Creation Domain Registration / Renewal Hosting Email Setup Other
Do you require any additional graphic design work?	Logo Brochures Online Brochures Flyers Business Cards Letter Head Envelopes Other
What is the mission or goal of the website? (What do you want the website to do?)
How many pages do you estimate the website to contain?	0-5 6-10 11-20 21-40 41-70 71-100>
Will this website be offering products / services for sale online? If yes, what type of products and/or services?
Will you be storing any data that requires strict security?	Banking Information Storing Customers personal contact information. Members only area. Other
Will visitors have to "log in" or will the site be accessible to everyone?	Visitors will have to "log in"! Accessible to everyone!
Does the website require a logo design?	Yes No Not Sure
Do you want the website to have flash?	Yes No Depends on the cost Not Sure
For the new website, would you like a custom graphic design or would you prefer to use a template (pre-made)?	Yes, I would like a Custom Graphic Design! A Template is fine! Not Sure!
Does your website require any on line marketing?	Website Optimization Keyword Search Linking Pay-Per-Click campaigns I don't know what types of online marketing is needed!
What other components will the website contain?	Mailing List Database Product List Product Images Flash Animation Video Computer Animation Contact Form with Mail Form Down loadable PDF Brochures Customer Surveys Advertisements Shopping Cart Newsletter-Online Online Payment Merchant Account (Visa/Mastercard) Company Profile Message Board Members Only Area
Please list other websites that you find appealing or would like to emulate. Please list the specific elements of the websites and specifically why you like them.
What are the company colours or preferred colours for the website?
Please tell us any other information you think is relevant.
How urgent is your project?	I needed it done yesterday! In a couple weeks would be nice! I'm more concerned about quality of work! I just want to know how much a website like this will cost! Not Sure!