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Contact Information |
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| Name: |
Last Name: |
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| Address: |
City: |
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| State/Province: |
Zip/Postal Code: |
Country: |
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Organization: |
email: |
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| Home
Phone: |
Work
Phone: |
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| Fax: |
Website |
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Web Site Reference |
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| How
many pages do you think your website should
have? |
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1
2
5
10
more
need help
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Please select, what is the purpose of
your website? |
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Personal
Business
Non-Profit
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What would be your site focusing on? |
Informative
Teaching
Selling products or services
Online portfolio for art, etc.
Other (please describe on the space below)
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| If
you know your target audience please
describe below |
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| If
you know the keywords clients would
normally use to find your business
online, please write them below, if not
please shortly describe what your
business is about |
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| What
regions or countries your company
serves? |
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| Do
you have any preferred websites? if so,
please provide the links of your
favorite websites below |
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What features you would like to have on
your website? |
Shopping
cart
Chat room
Comments
Image gallery
Contact or request of information forms
Other (please describe below)
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| Do
you have a logo for your website or do
you need graphic design services? |
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Yes,
I have a logo
No,
I need graphic design services
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| Do
you have hosting? |
Do
you have a domain name? |
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Yes
No |
Yes
No |
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| If
you have a domain name or domains names,
please list them below, if not tell us
what your choices would be (use comma as
separator). |
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| If
you are looking for an e-commerce, how
many products are you planning to sell? |
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1
10
50
100
150+
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| When
do you need your website to be ready
for? |
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| Are
you on a budget? if yes, what is your
budget? |
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Yes
No
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Please describe what your dream
website should look like. Provide any
links if applicable |
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