|
We
'd like to get to know you
|
|
Your
Name (required):
|
Company Name (required):
|
|
|
|
|
Job
Title (required):
|
Telephone
Number
(area code + phone)
(required):
|
|
|
|
|
E-mail
(required):
|
Web site address
(if you have one) |
|
|
|
|
Street
Address (required):
|
City
(required): |
|
|
|
|
State
or Province (required): |
ZIP
or Postal Code (required): |
|
|
|
|
Country
(required): |
Industry
(required): |
|
|
|
|
How did you
hear about us?
(required): |
Main needs for having your business online?
(required): |
|
|
|
|
Name of Person in charge of making Decisions about
the web site? (required): |
| |
|
|
Web
site status |
|
If
you have a web site, How well is your website serving your
Company? |
|
|
|
What
has been done to promote your website?
(required): |
|
|
|
Web
Promotion is mainly performed (required): |
In-House
Outsourced
None |
|
Name 3 Main
things you
like your website do more of?
|
|
|
|
|
|
|
Who do you consider
your competitors and/ or name other sites
you have seen which you like? |
|
|
|
|
|
Services / Project Needs -
Please Note
The
more details you provide, the easier and
more accurate our quote will be!
|
|
Web
Design / Development:
Free
Template Design
Custom
DesigneCommerceCustom
Development
|
|
Web
Hosting |
The site will be hosted by: |
|
|
|
Domain
Name Registration: We
invite you to check out our specials rates
for Domain Name registration
|
|
Do you own
a domain name?
|
|
|
|
Do
you want us to check the availability of a
domain name? |
|
|
|
|
| Web
site positioning analysis |
Domain
to evaluate: |
|
|
|
|
|
|
|
|
|
What is
your total budget for this project?
(required):
|
|
|
What is
your Monthly budget for this project?
(required): |
|
|
How quickly do you
plan to proceed? (required): |
|