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Last Name: |
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Email: |
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Company Name: |
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City: |
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State/Province: |
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Country: |
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Phone Number: |
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Fax Number: |
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Information on the website: |
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Do you want a new website or want a re-design/development? |
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New |
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Re-design/Development |
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Explain your requirement as much as possible:
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Version Simple
Version |
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Check all that apply: |
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Forms (Contact Forms, etc.) |
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Password/Members Only Area |
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Database Driven |
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E-commerce / Shopping Cart Solutions |
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Other Custom Scripting/Programming |
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Flash Intro |
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Flash Animation |
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Total Flash Website |
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Virtual Tours |
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E-Business Application Development |
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Chat Room |
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website Administration Section |
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Bulletin Board / Forum |
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Content
Management System |
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Other, please specify |
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Estimated number of pages in your website |
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Do you have a specific date you would like your project
to be completed? If so, when? |
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Please provide us with a list of competitor websites
or sites you feel are comparable to your goals : |
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Maintenance Section: |
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How often do you foresee the need to update your website? |
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None
Daily
Weekly
Bi-weekly
Monthly
Yearly |
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others
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What type of changes would you foresee? Please check
all applicable. |
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Text Changes
Graphical Changes
Price Changes |
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Individual Page Changes
Full Renovation |
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Others |
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How much would you be willing to pay for the web design
service? |
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below
$500
$500 - $1,000
$1,000 - $2,000
$2,000 and above |
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