Web design form

Who is your sales rep?

Who is our contact for this project?

First NameLast Name

How can we reach our contact?

Area CodePhone Number

Email Address

Business Name:

Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you or your company have any licenses, memberships or affiliations that you'd like to highlight on your website?

Who is your target audience/customer? (Age, gender, interests)

Why do you think you need this website?

What could happen if you don't get this website?

Why should people seek you out instead of someone else?

When is your goal launch date for your website?

MonthDayYear

What kind of budget will we work within?

What services are you interested in?

What would you like your domain name to be? If you already have a domain, please state it here.

If you already have hosting, who are you hosted with?

Do you plan to maintain and update your site yourself?

If maintaining it yourself, will you require training?

What is the purpose of this project?

What web pages do you envision having? (i.e. About Us, Contact Us, Services, etc)

Is there anything that should NOT be on your website?

If you were using a search engine to find your website, what words would you use?

What are your color preferences? Please mention at least 3 colors of your choice:

What are four or five other websites that you love, and why are they attractive to you?

When people visit your website, what would you want them to do? Please check all that apply.

Do you have any preferences as far as images for your homepage?

Are there any additional features you wish to add which have not been mentioned above?

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About Your Organization