*(denotes required field)

Name:*

E-Mail Address:*

Telephone*

Do you currently have a website?

Yes No

If yes, what is the URL?

If no, domain name you have in mind

About your Organization/Company

Your mission, overall aims & objectives or products & services.)

What is the target audience for the Web site?

What best describes your current needs?

New Complete Site
Existing site needs redesign
Need web hosting only

What is the purpose of your site?

Internet presence
Attract local customers
Broaden customer base
Sell products
Provide information
Publish a newsletter
Other

What services will your site need to provide?

Contact / Info request or Feedback form
Streaming Video and/or Audio Online
Surveys/Polls
Logo, Banner or other graphic design
Photo gallery
Custom HTML Page(s)
News, Announcements, Events
Flash Intro, slideshows, or other animation
Map and driving directions
Downloadable / Printable Documents
Secure online shopping cart
Event calendar
Password protected user areas
Newsletter / Mailing List

Number of pages in site?

Number of photos in site?

Number of products in site?

Do you need content written for site?

Yes No

List the URL's of some sites you like

What elements of your web site do you have ready to use? (A company logo, the mission statement, graphics, or photographs?)

Define the aesthetic style you are looking for? (Light-hearted, trendy, cutting-edge)

Do you need photographic services?

Yes No

Will you have a site editor?

Yes No

Will you need ongoing site management services?

Yes No

When would you like to have this project completed?

2-4 weeks 1-2 months 3-5 months 6 months or more

What are the Short-Term goals for your site?

What are the Long-Term goals for your site?

Other Comments

What day of the week is best to meet with designer?

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