Your name:  

Your email address:  

Your phone number (with area code):  

Just in case we have trouble with your email address or if you need us to call you.

I'm interested in hiring you but I prefer talking to you on the phone. Please contact me ASAP.

I'm interested but I have questions:

Feel free to fill in any and all details below. If you aren't sure about something, no worries we'll get there.

What do you need?

A brand new site. Number of pages if you know:

Redesign current site

Monthly web site maintenance

Domain Registration and Hosting

Current Domain Name (URL) if you have one: 

Do you need a domain name registered?

Yes
No

Do you want hosting set up for you?

Yes
No

What does your business do?

Purpose of your site (your goals, what you'd like to see happen by having an online presence with your web site):

Do you accept credit cards?

Yes
No
We would like to accept cards

Do you need a shopping cart?

Yes, I need a shopping cart for approximate number      of products (and/or services)

What other sites do you like that are similar to the type of design you want?

What do you like about them?

What graphics, photos, logos and other art do you have?

Do you have a deadline when the site must be completed?

If yes, when:

How would you like us to contact you to discuss your web site quote?

By email.

By phone.

By setting up a meeting.

Thank you for visiting!

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