Required Information

Name:

Email address:

1.  

What type of Web site design services are you looking for?

Design of an entirely new Web site
Complete redesign of an existing Web site
Upgrade to an existing Web site
Maintenance of an existing Web site
Other (please specify)

2.  

Are you interested in e-commerce related services (selling products, accepting payments, etc.) or more general Web design work?

E-commerce related services
General Web design services

3.  

Which of the following describes your Web design needs?

Exploring Web design options
Setting Web design budget
Have Web design budget, ready to begin

4.  

What is your total estimated budget for this website design project?

$300-1499
$1,500-2,499
$2,500-4,999
$5,000-9,999
$10,000-19,999
$20,000-49,999
$50,000+

Please be aware: very small and simple Web sites, with little to no customization, typically start around $500-$800. Any additional functionalities, customization and/or increases in the size of the website will increase the budget required.

5.  

When would you like the Web design project to start?

ASAP
In 2 weeks
In 1 month
In 2 months
More than 2 months

6.  

Have you already registered a domain name for this Web site?

Yes
No

7.  

Have you already arranged for hosting services for this Web site?

Yes
No

Optional Information

Phone number:

1.  

Besides the copy/text, will you be providing any of the following materials for the site design?

	No - we are looking for help with all other aspects of our Web site
	Yes - We will provide images/graphics for our Web site
	Yes - We will provide layout/site map for our Web site

2.  

If you are looking to upgrade or redesign your current Web site, please indicate the URL:

3.  

Please give any additional requirements/comments you may have for your Web site (secure pages, database, etc.).