Web Design Information Request Form

First Name:

Last Name:

Business Name:

Phone:

E-Mail:

Web Site:

Services interested in:

Web Design
Web Hosting
Site Maintenance
Online Marketing

What domain names are already owned?

What names will need to be registered?

Do you need a redesign or a new web site?

New web site
Redesign my current web site at:

What services do you want to offer on your web site?

What type of products do you want to sell on your web site?

Do you currently have a logo that can be emailed to us in either print or disk form?

Yes No

Do you have existing material for your product/idea in the form of brochures, pamphlets, CDs, video, flyers, etc? If yes please explain:

Do you have your text content already created in print or computer generated form? How much is already written?

Do you have a guess as to how many pages the site will include?

How many photographs or other graphics would you say are likely to be included on the site?

Design Style/Tone? (Conservative, progressive, friendly, formal, casual, serious, expert, humorous, service-oriented, professional.) Message you want to convey?

Do you have any existing artwork or corporate color schemes that you want incorporated into your site?

Feedback/contact form? Other scripting or database-driven applications?

If you need a redesign, let us know EXACTLY what you do NOT like about your current site and what you would like to change :

Give us a brief overview of your project to help us determine how many pages your site will be. As an example, consider the our sample outline.

It is very helpful if you are able to email or fax an outline similar to this.

What is the desired time frame for development of this Web site? Date of completion? When would you like development to start?

Do you intend to maintain the web site yourself, or you would like to sign up for Web Site Maintenance Packages?

I will maintain myself.
I would like to have CMS (Content Management System).
I would like to signup for a Maintenance Package.
I am not sure.

List website addresses that you have found that best demonstrate the type of site you would like designed for your business. These addresses can be from a related or separate entity from your business. Areas to take into account are its navigation, layout, topics to include, amount of content on a web page and site as a whole, its graphics and overall functions.

Site 1:

Site 2:

Site 3:

What is the purpose of your site?

Bring in New Clients/Customers
I want to setup an Online Store
Online Subscriptions and Payments
Educational, Training or Instructional
Extend Marketing Reach
Informative
Starting Internet Presence
Other, Please Explain:

What audience(s) are you targeting?
Businesses? Youths? Mothers?
Who will be looking for your site?
Who will become interested if they reach your site accidentally?

Audience Reach?

Select Local Regional National International

Please relay any special instructions or concerns you may have here.

What is your allocated budget for your web site?

Select $1,500 - $2,500 $2,500 - $5,000 $5,000 - $10,000 $10,000 - $30,000 $30,000 - $50,000 $50,000+

How did you find us?

Other

Thank you.