Your
Company Name:
Your Company URL:
Briefly describe your company's business:
Your Name: (First, Last)
Contact Email:
Phone Number: include Intl.
Country Code if outside USA
Street Address/Suite #:
City:
State/Province:
Country:
ZIP/Postal Code:
Please summarize your
web project in at LEAST a few
sentences.
Anticipated budget:
Is
this for a NEW website design or for
a "face lift" of an existing website.
NEW
Facelift
Do you have a "Domain Name" registered
already (www.yourcompany.com)?
Yes
No
Please
tell us about your Site Design needs:
(please check all that apply)
Interface Design
Marketing or Strategy Assistance
Banner Ads
Media or Ad Buying Assistance
Logo(s)
Animation
Illustration
Video
Audio
Flash Animation
Please
enter URLS of any sites whose styles
you like to assist us in knowing your
tastes:
Please enter pertinent URLs of your
COMPETITORS sites, if you'd like us
to be aware of them to ensure superiority:
Programming/Engineering language
needs or current backend systems to
be integrated:
Please tell us about your Backend
Development needs: (check all
that apply)
Online Catalog or Store Development
Legacy Systems Integration
Shared Messaging Environment Development
User Input or Data Capture (forms
processing)
Newsletter Setup
Search Engine Positioning
Web Site Hosting
Chat Room Setup
Message Board Setup
Banner Ad Server
Portal Style Links Site (Yahoo style
drill down directory)
If 'Other', please describe additional
backend site services you need:
How soon do you need your project
completed?
Timeline is flexible
1 week
2 weeks
1 month
2 months
3-4 months
5-6 months
7-9 months
10-12 months
How soon do you want to begin your
project?
Immediately
Timeline is flexible
1 week
2 weeks
2 months
1 month
Not Sure
Any additional comments or questions
for us:
