Mr.
Ms.
Type of site:
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Small Business
Corporation
Personal
Non-Profit
Religious
Other
Budget:
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Undecided
$500-$1000
$1500-$2000
$2000-$2500
$2500-$3000
$3000-$3500
$3500-$4000
$4000-$4500
$4500-$5000
$5000+
First Name:
How would you like us to
contact you?
Last Name:
Referrer:
Select One
Word of Mouth
Friend
Banner
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Alta Vista
Excite
LookSmart
AOL Netfind
Lycos
MSN
Yahoo!
AskJeeves
Where2Go
InfoSeek
HotBot
WebCrawler
SearchIt
Netscape
Jayde
Infohiway
What-U-Seek
Searchit
Other (Specify Below)
E-Mail:
If Other:
Phone:
Brief explanation of what you
want:
Pages:
Undecided
1-3 Pages
3-5 Pages
6-10 Pages
11+ Pages
I am mostly concerned about the:
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Total Price
Site Functionality
Visual Appearance
Concerned About
Everything
Other (Specify Below)
If 'Other' please specify:
Are we redesigning your
current site?
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Yes (See Below)
No
What is the current address of
the site?
How often do you anticipate
your site will be updated?
No Updating
Occasionally
Daily
Weekly
Monthly
Quarterly
Other (Specify Below)
Explain:
Do you have a list of any of
your competitors? (If so, please list their addresses below)
Address 1:
Address 2:
Address 3:
Address 4:
Address 5:
Will you require hosting services?
Select One
Yes
No
If yes, please specify which
hosting plan fits you best? View our Hosting
Plans
Plan 1:
200 MB Space & 2,000MB
Bandwidth
Plan 2:
300 MB Space & 5,000MB
Bandwidth
Plan 3:
750 MB Space & 10,000MB
Bandwidth
Plan 4:
1,000 MB Space & 15,000MB
Bandwidth
Plan 5:
1,500 MB Space & 20,000MB
Bandwidth
I am not sure which plan will be best for my site:
Get a recommendation based on the site made:
Select the following extra
items you might require:
Logo Design
Domain Name Registration
Banner Design
Site Maintenance
Search Engine Optimization
Merchant Account
Contact Forms
Credit Card Processing
Search Site Function
Shopping Cart
Photo Gallery
Pay Pal Shopping Cart
Guest book
E-Commerce Security ( https://)
Custom Photography
Training (Specify Below)
Online Catalog
Please rate the importance of
visual appearance:
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Very Important
Important
Average
Somewhat
No importance
Keywords that will describe
your web site, products, and services:
Do you have the content
pre-typed? (Text for site)
Select One
Yes
No
Do you need help writing or
correcting the content?
Select One
Yes
No
Estimated time of site
completion:
Does Not Matter
Depends On Price
1-7 Days
1-2 Weeks
3-4 Weeks
2 Months
3 Months
4 Months+
Target
audience & business goal (Who is the web site geared towards?)
Any additional
information you wish to include:
Please click submit only once.
