<%@LANGUAGE="JAVASCRIPT" CODEPAGE="1252"%> Request Website
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design

Request Web Site Estimate

First Name

 

Last Name

 

Email

 

Phone

 

What is the purpose of your website?

Do you have an existing web site?
Yes No

Do you need a new or updated site design?
Yes No

Is search engine optimization (SEO, the ability for someone to search for you) important?
Yes (recommended) No

If design is required, how would you describe the look of your website?
(examples: high-tech, earthy, health-minded, family-oriented, corporate)

How soon would you like your web site available?
One week Two weeks Time not a concern

Will your site require secure access?
Yes No

Comments

Will you need website hosting?
Yes No

Do you have a website (domain) name?
Yes No

If no to the above what domain would you like?
www. .com .net .org