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Company name |
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Contact name * |
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Email Address * |
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Mailing Address * |
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City, State, Zip * |
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Phone Number * |
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Fax |
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How do you prefer to
be contacted? |
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Why do you want a web
site? |
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Do you already have
a domain registered?
(www.yourdomain.com) |
Yes
No |
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If yes,
what it is?
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If no, do you intend to
register one?
Yes
No |
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If yes, what are some possible choices? |
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Who
is your target market?
(check all that apply) |
International Consumers
Local Consumers
Family and Friends
Specific Geographical Regions
If Geographical please elaborate:
Other, please specify
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Primary Goal
for Web Page |
To Sell Services
To Sell Products
Information
Personal
Events
Other
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Your Deadline Date |
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Web Site Title |
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Site and/or Company
Description |
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10 Keywords
(These are words that people might use to find your site
with search engines) |
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Do you have a logo or
other images/photos that you intend to use? |
Yes
No |
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If yes, are they digital
or will they need to be scanned? |
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How many pages do
you expect the site will contain? What will the "buttons"
say that users will use to link different pages of your site? |
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Give examples of web
sites you like (please include the URL) |
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What color
and feel do you envision? eg. bright, bold, primary
colors or soft, muted, tranquil colors |
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Any other comments or
questions? |
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