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Contact:
Company:
Address:
City:
State:
Zip:
Phone:
Fax:
E-mail:
Website:
This website will be used for (check all that apply):
Informational:
Providing your visitors sales and contact information;
ECommerce:
Offering online shopping, service payment options, or order placement;
Organizational:
This website is for a government, religious, or other non-commercial entity.
I want to focus on:
Style/Appearance
Layout/Navigation
E-Commerce
Other:
Please list some some websites you like along with the features that interest you.
1.
What to note:
2.
What to note:
3.
What to note:
Are there any specific colors or fonts you like?
No
Yes
Do you wish to have photos on your website?
No
Yes If yes, approximately how many?
Under 10
11 - 20
21 - 30
31 - 40
41 - 50
Over 50
How many email accounts will you need?
None If yes, approximately how many?
0 - 5
5 - 10
11 - 20
21 - 30
31 - 50
Over 50
Do you already have a web-hosting account?
No
Yes If no, would you like information about our hosting options?
Yes
Provide a description of the website you wish to receive.
How would you like to be contacted about your quote?
E-mail
Fax
US Mail
In Person
Referred by:
Please review the quote and make sure you have provided all the information needed along with any questions or comments.
Click Submit when you are finished.