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Website Design
Graphic Design
Photography
Other Online Services
Logo Design
Promotional items
SEO
Writing
Video Product
Social Media Services
Printing
Other
How did you hear about us?
Referral from
(Person Name/Company/Google)
*
First Name:
*
Last Name:
Company:
Address:
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
*
Phone:
*
Email:
Your Current website:
Product/Service on your website:
What are you selling or what is your business about?
Objectives/Goals of website:
Providing info about your company, selling online, collecting data...?
Your Target Audience:
Who are your clients, who do you sell to?
How do you want to look and feel like?
How do you want to be perceived?
Provide 5 websites that reflect the look and feel that you are looking for.
Point out the specific parts that you like (ie. colors, graphical treatments, etc...)
List competitors websites
Tell us what you need:
Design & Content:
I need the following...
Select All/None
Custom Website Design
(vs. template)
Template Design
(vs. custom)
Logo
Writing/Editing
Stock Photos
Original Photography
Slideshow/Banner
Photo/Video Gallery
Audio/Music
Video/Online Spokesperson
Other
Functionality:
I need these capabilities...
Select All/None
CMS
(Content Management System to edit website on my own)
Blog
Contact form
Auto-responder
Sign up for Newsletter
Online Payment Processing
Login/Registration
Member Profile
Forum
Uploading files
Other
Once on my website, I want users to:
Select All/None
Call me
Make my phone # big!
Fill out form
and forward it to my email.
Email me
Sign up for newsletter
Review samples of work
Find answer to FAQ
Buy online
Post a comment
Register
Other
Social Media:
Select All/None
I ONLY need a
Link to Facebook, Twitter, LinkedIn, YouTube only
Facebook / Twitter / YouTube setup/management
Help! I don't know what I need.
Other
SEO:
I need additional search engine optimization...
Select All/None
Basic SEO
Local Search
Article Writing
Link Campaigns
Pay Per Click
Help! I don't know what I need.
Other
What pages do you need?
Here is a list of common pages/sections/links:
Home
About
Products
Services
Photo Gallery
Video Gallery
News
Pricing
Events
Blog
FAQ
Testimonials
Contact
Careers
Sitemap
Facebook
Twitter
YouTube
LinkedIn
Subscribe to Newsletter
Download Brochure
Forms
Buy/Shop
Specials
Resources
Links
Partners
Wholesale
Login
Privacy/Terms
Budget/Range:
under $1,500
under $2,500
under $5,000
under $10,000
$10,000+
I have no budget
I have no idea how much a website cost. I’m shopping around for now.
Comments:
If we are unable to assist with your project, we are glad to forward your information to a design partner.
Yes, please do.
No, thank you.
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