First Name
*
Last Name
Address
Email Address
*
City
Phone Number
State
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
What type of web service will we be providing you:
*
New Web site Design
Re-Design of
Maintenance/Update
If you need to create a new site we can register a domain name for you. Please list your top three picks for a domain name:
1)
2)
3)
If you already have a domain name registered and have a hosting company, please list them below:
Domain Name
Hosting Company
Do you have a Logo/Main image to design your site around?
*
NO
YES
What colors are you partial to for the creation of your site?
*
Do you have any images for your site?
*
NO
YES
Will you provide all the text for your web site?
*
YES
NO
If you have any existing site examples you would like to model your site around please list them here:
How many pages will you need for your web site?
*
1-4
5-10
11-15
15 or More
What type of business/Organization are you promoting?
*
What types of visitors do you expect to your site:
*
Demographics
Customers
Buyers
Sellers
Other
Please explain:
*
What is the purpose or goal of your web site?
*
Promote Products
Sell Products
Create Customer Awareness
Provide Customer Service
Gather Customer Feedback
Distribute Company Information Via Your Web site
Provide a Community Service
To Encourage Customers to Contact Us By Phone, Post, or Email
To Provide General/Specific Product Information
To Build Customer Loyalty
To Provide General/Specific Product Information & FAQ's
Other
Will your visitors be ordering products online?
*
NO
YES
Will you need full motion video on your web site?
*
NO
YES
Will you need an audio track for a web intro or Home Page?
NO
YES
Would you like to add forms to your site to collect customer/visitor information?
*
NO
YES
What would be the purpose of collecting your customer's information?
*
Will you need a banner?
With Roll-Over Images
Flash (Animation & Motion)
Navigation (add your page buttons along with your banner)
Do you require ongoing maintenance and content updates?
*
NO
YES
How often will you need content to be updated on your web pages?
*
Rarely
Once a month
Weekly
Daily
Would you like the ability to update content on your web site yourself?
NO
YES
Do you know any web site addresses for whom you would consider your competition?
*
By what date would you like to launch your site?
What do you like/dislike about their web sites?
Please provide a list of functionality you would like to have in your site. (Provide existing site examples where needed)
*
TELL US ABOUT YOURSELF
What is your work background?
*
Do you have a technological background?
*
NO
YES
What is your level of understanding the web/internet?
*
Have you developed a portal or web site before?
*
NO
YES
Please indicate the approximate budget you have in mind for your web site?
*
If this project is your responsibility please indicate, and/or how involved will you be in the process of developing the site:
*
Do you have any short term or long term goals for your web site?
*
What will make this web site a success for you?
*
How important is it to you to get a high rank on major search engines like Google, Yahoo, and MSN?
*
Please list 5 Keywords that you think your potential visitors will enter into a search engine (like Google) while searching for a site like yours:
*
May we place a small icon at the bottom of your pages that read "designed and developed by Team Tech Pros"?
*
YES
NO