* Name
* Email Address
* Email (again)
* Company
* Phone
Best time to call?
Do you currently have a website?
If yes, what is the URL?
What primary products a/o
best describes your current needs?
----- Select One -----
New Complete Website
New Complete eCommerce Website
Existing site needs redesign
Existing site needs new features
Need webhosting only
What is the purpose of your site?
----- Select One -----
Internet presence
Attract local customers
Broaden customer base
Convey an image
Provide information
Sell a product(s) online
Sell information
Collect user demographics
Publish a newsletter
Other
What services will your site need to provide? (check all that apply)
Do you need content written for your site?
List 3 competitor websites and what you like/dislike about them
1. http://
2. http://
3. http://
Other services desired:
What are some short-term goals for your site?
What are some long term goals for your site?
When would you like to have
----- Select One -----
less than 2 weeks
2 to 4 weeks
1 to 2 months
3 to 4 months
5 to 6 months
6 months or more
What is the range of your buget?
----- Select One -----
undetermined
less than 1,000
1,000 to 2,500
2,500 to 5,000
5,000 to 7,500
7,500 to 10,000
10,000 to 15,000
over 15,000
When do you need this proposal by?
----- Select One -----
no more than two weeks
within 1 week
within 5 days
within 4 days
within 3 days
within 2 days
same day
Additional comments a/o concerns:
How did you find us?
----- Select One -----
Search engine
Altavista
AOL
Google
MSN
Overture
Yahoo
Newspaper
Phone book
Word of mouth
Other
