*Required Field

*Name

Location:

*Email Address
(We cannot reply without your email address.)

Is this a new Website?
Yes
No

If No, is it a re-design?
Yes
No
What is the current URL of your Website?

What type of 'Image' do you want your Website to convey?
Please select one:
Conservative Professional Warm/Friendly Children/Family Colorful/Bright/Fun Eye-Catching

Select which amount describes the 'budget' you have in mind for your Website:
Under $300 $300 - $600 $600 - $1000 Over $1,000

Will you be providing the actual 'content' for your Website, or will you need us to write it for you?
Yes, I will provide all the content
No, I need you to write it

What type of information will you want to include in your Website?
Please select one or more:
Home/Introduction Page
Service Information Page/Pages
About You/Your Company
Product Information Page/Pages
Printable Order Form Page
Online Order Form Page
Website Updates and Announcements
FAQ's Page for Your Viewers
Online Newsletter Page
Links to Related Businesses Page
Contact Details Page
Other (please describe below:)

If 'other' selected, please detail your description here:

Do you need space on the Internet to 'host' your Website?
Yes  No

Do you need a Domain Name registered?
Yes  No

Do you want custom graphics for your Website?
Yes  No

Do you need a logo and banner designed?
Yes  No

Do you need someone to 'update' your Website periodically?
Yes  No

If Yes, will you need the updates:
Daily
Weekly
Monthly

EXTRAS:

Will you require 'extra' promotion done for your Website?
(i.e., submission to search engines)
Yes  No

Please provide us with any other information which will help us in providing a quotation:

Have you given us your email address? We appreciate you providing us with your email address, so we can forward our quotation or answer your queries.

Thank you for your time, we will get back to you within 24 - 48 hours of submission, or the next working day if submitting on a weekend or holiday.

Upon receipt of this form, we will submit a proposal to you for your review. We will be happy to discuss with you the best options for your budget and your web design needs.