This form is designed to get our design team started. Fill in as much info about your business, organization or project as you can.
Name Business Name Street Address City State/Province Zip/Postal Code Country Phone # Fax # Existing email address Site Title Web Site Description Keywords that describe your site. ie, web design, html, A good title is between 5 and 20 words. Make you title not just your sites name, but also be a quick description. The Description should be a good description of your site. Put keywords in the description . Keywords should be relevant to your site. Your meta tags help search engines in ranking your site. Your keywords should be single words or small two word descriptions of your business.
Business Name
Street Address
City
State/Province
Zip/Postal Code
Country
Phone #
Fax #
Existing email address
Site Title
Web Site Description
Keywords that describe your site.
Other pages you may need...
QTY DESCRIPTION Sales Pages Qty: Customer Feedback Forms. Qty Link Pages to other sites. Qty Other Pages. Qty Do you already have a registered domain name? Yes No http:// If not list some choices Do you have internet access? Yes No If so, with who? AOL Earthlink MSN US West Net Zero Prodigy Other Business Address (If different then above) Street Address Address (cont.) City State/Province Zip/Postal Code Country Phone # Fax #
http://
If not list some choices
Do you have internet access?
If so, with who?
Address (cont.)
Select any of the following options that apply: Check all options needed ..
Page counter
Guest Book
Banners
Custom Link Buttons
Video
Do you have business logos that need to be designed of scanned?
Yes No
What other pages or comments do you have ... ?
BILLING. This is not on a secure server, you may also call our office with this info. Credit Card VISA MasterCard American Express Diner's Club Discover Cardholder Name Card Number Expiration Date Check # P.O. #
Card Number
Expiration Date
Check #
P.O. #
We will contact you within 1 business day.
Client WebMail Interface