| Contact Information |
| Name: |
|
| Phone Number: |
|
| Fax Number: |
|
| Email Address: |
|
| Business Address: |
|
| How would you like to be contacted? |
|
| Business Information |
| Business Name and Type: |
|
| New to the Internet? |
|
| Do you already have a Web Site? |
|
| If so, what is your web address? |
|
| Internet Strategy |
| Can you describe your goals for your online
business? |
|
| What type of audience are you trying to attract? |
|
Give a general overview of web site:
(e.g. Online Store, information about company, products, links to outside vendors, etc.) |
|
| Additional Questions &
Content From Client |
| Do you have a company logo? |
Yes No |
| Preferred Color Scheme? |
|
| 3-5 Sample URLs that you like:> |
http://
http://
http:// |
| Will site need contact/information form? |
YesNo |
| If yes, please describe the type of data the
form will collect: |
|
| Budget for project: |
|
| Products & Services
You Are Interested In |
| Site Add-Ons |
Discussion Board |
| |
Guest Book |
| |
Site Statistics |
| |
Site Counter (free!) |
| |
ODBC Connection |
| |
Form-to-file posting |
| Ecommerce |
|
| Web Marketing |
|
| Database Work |
|
| Programming |
|
 |
|
+ Time and Your PC IP-Address! |
