Please provide the following contact information:
Name Street Address Address (cont.) City State Zip code Phone E-mail Web Address
Name
Street Address
Address (cont.)
City
State
Zip code
Phone
E-mail
Web Address
Date Service Is Needed To Start?
-- mm/dd/yy
Company Industry:
Type of Business
Service Needed:
New Site Development Site Upgrade/Redesign
Size Of Company: Small Business Medium Business Large Business Other
Number Of Pages Needed: 1-10 11-15 16-20 21-25 26-30 31-35 36-40 41-45 46-50 more than 50
Additional Service Needed:
Web Hosting Database Design Real-time Credit Card Processing Site Statistics E-commerce/Shopping Solution Search Features
Will you accept Credit Cards Online? Yes No
Will your site sell products or services?
Yes No
If yes how many items? Less than 10 10-25 26-50 51-75 76-100 101-150 151-200 201-250 251-300 301-350 351-400 401-450 451-500 Over 500
Multimedia:
Flash Animation Video Clips/Feed Music Virtual Tour
Purpose Of Site? Sell Products Marketing Tool Information Resource Personal Other
What kind of site interest you? Simple, Streamline Serious, Stable Exciting Dynamic Highly Graphical Flash Site/Flash Intro
Budget Range: $500-$1200 $1200-$2500 $2,500 - $5,000 $5,000- $7,500 $7,500 to $10,000 $10,000 to $20,000 $20,000 to $40,000 $40,000+
How would you like to receive your quote? Email Microsoft Word Attachment Regular Mail Phone Set Up Meeting
Please give a brief description of your company as well as any website address that has a similar look and feel to what you want.
How Did You Hear About Us?
Security Code
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