| First Name: |
|
| Last
Name: |
|
| Company
Name: |
|
| City
and State: |
|
| Phone
Number: |
|
| Email
Adress: |
|
| How
would you like to be contacted? |
E-mail
Phone |
| |
|
If
you currently have a website, please supply the website
address here. (www.yourwebsite.com)
|
|
| |
|
| Will
you need a domain name (www.yourwebsite.com) registered
for your website? |
Yes, I need a domain name registered.
No, I already have a domain name registered. |
| |
|
|
Will you need hosting for your website? |
Yes, I need hosting for my website.
No, I already have a hosting provider.
(Please supply the name or the website address of your host)
|
| |
|
| How
many pages will you need? |
|
| |
|
What
type of Website design services are you looking for?
(new design, redesign) |
|
| |
|
| Will
you be selling products? |
Yes
No |
| |
|
| What
types of products will you be selling? |
|
| |
|
|
What is your total estimated budget for this website design
project? |
|
| |
|
| Additional
questions or comments. |
|
