Web Development Client Intake Form

Website Design & Development Questionnaire

Company Interview
Full Name*
First NameLast Name
Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Phone Number*
Area CodePhone Number
E-mail*
Business Name:
Please write your mission statement or company slogan, if you have one:
Does your company have a logo? If so, please attach below:
How long have you been in business?
How many employees does your business have?
Do you or your company have any licenses, memberships or affiliations that you'd like to highlight on your website?
Have you already registered a domain name? If so, what is it and what company did you use to register?
Who is your target audience/customer? (Age, gender, interests)

Website Interview/Expectations
What is your timeline for completion of the website?
What services are you interested in?
DOMAIN REGISTRATIONWEBSITE DESIGN & DEVELOPMENTE-COMMERCE/SHOPPING CARTBROCHURE DESIGNBUSINESS CARDS/LETTER HEAD DESIGNINTERNET MARKETING & PROMOTIONGRAMMAR & TEXT EDITINGWEBSITE MAINTENANCEOTHER (PLEASE DESCRIBE BELOW)
What would you like your domain name to be? If you already have a domain, please state it here.
If you currently have a website, why are you designing/upgrading? What would you like to see/change/improve?
What is the purpose of your website? Check all that apply:
E-COMMERCE/ONLINE SALESIMPROVE CUSTOMER SERVICEPROVIDE INFORMATION ON PRODUCTS & SERVICESBROADEN YOUR CUSTOMER BASEKEEP IN CONTACT WITH CURRENT CUSTOMERSIMPROVE SITE DESIGN & LAYOUTIMPROVE FUNCTIONALITY & NAVIGATIONOTHER (PLEASE DESCRIBE)
What are your color preferences? Please mention 3 colors of your choice:
Do you have any reference or competitors website that you would like to submit for review for the design process? Please list the website URL's & specific aspects of the site's that you like:
Please provide a quick layout for your website (sitemap). This should include all pages and subpages for your website. Example: Services > Weddings, Graduations, Portraits
When people visit your website, what would you want them to do? Please check all that apply.
HIRE YOU TO PERFORM SOME SERVICEJOIN YOUR COMPANYCOMMUNICATE WITH YOUINFORM YOU ABOUT SOMETHINGSEEK INFORMATION ABOUT YOUR PRODUCTS, SERVICES OR ORGANIZATIONTO BE ENTERTAINEDCOMPARISON SHOP OR TO BUY A PRODUCTCONNECT WITH OTHERS OF SIMILAR INTERESTSREGISTER FOR AN ACCOUNT, IF YES, PLEASE DESCRIBE.VIEW BROCHUREVIEW A CATALOGORDER A PRODUCT OR SERVICE ONLINESEEK SOME INFORMATION
Would you like an intro page before the homepage (landing page)? With or without flash?
Do you have any preferences as far as images for your homepage?
Do you have any additional text/content for the homepage?
Upload image(s) below:
Please submit any other information pertaining to your site below.

Advanced Website Options
Please select any of the following additional features you would like:
ABOUT USCONTACT INFOPERSONNEL BIOSTESTIMONIALSFAQ'SSERVICE/PRODUCT DESCRIPTIONSEVENT CALENDARCLASSIFIEDSGUESTBOOKCHAT ROOMOPINION POLLSHOPPING CARTLINKSPHOTO GALLERYCONTENT MANAGEMENTMAILING LIST (ANNOUNCEMENT ONLY) THIS IS WHAT YOU USE TO SEND OUT ANNOUNCEMENT OR EMAIL NEWS LETTERS.MAILING LIST DISCUSSION GROUPONLINE MESSAGE BOARD ON FORUMCONTACT, SUBSCRIPTION, SURVEY OR FEEDBACK FORMSPASSWORD PROTECTION FOR CERTAIN PAGESSITE SEARCH ENGINEMUSIC CLIPS LISTEN/DOWNLOAD/UPLOADVIDEO CLIPS VIEW/DOWNLOAD/UPLOADFILE UPLOAD (TYPE OF FILE)NEWS FEED
How will you be accepting payment through your website? Please check all that apply.
TRADITIONAL PROCESSING (CHECKS, MONEY ORDER, ETC)MANUAL CREDIT CARD PROCESSING (PROCESSED BY THE MERCHANT)REAL-TIME CREDIT CARD PROCESSING (AUTOMATICALLY PROCESSED ON CHECKOUT)N/A
Are there any additional features you wish to add which have not been mentioned above? Please mention here:
Should be Empty: