Company Name *
Your Full Name: *
E-mail:
Phone Number
Launch date (e.g. 08/05/2008)
Is your launch date fixed or flexible? Fixed Flexible
Project Budget $1,000 - $1,500 $1,500 - $2,000 $2,000 - $3,000 $3,000 - $5,000 $5,000 - $10,000 $10,00 - $20,000 Greater than $20,000 Other. Please, contact me.
Services Desired
Describe briefly your project.
What are the goals of your project? (e.g. To make a sell, to increase visibility, to show your portfolio...)
Site desired Brand new Site Re-design of an existing website Maintenance or upgrade Template Design only Other, contact me.
How many pages are required? Could you list them all? e.g. Home, About, Portfolio, Contact...
If E-commerce, how many products will you sell? Less than 50 products 50 to 100 products More than 100 products Don't know yet
URL of Web sites you like e.g. http://site.com
Competitors URL e.g. http://competitor.com
Current Web site URL (if applicable)
Domain Information Need to Register a Domain Already have a domain Don't know, contact me Not Appicable
Website Hosting Information Need help me to find a host Already have a Host Don't know, contact me Not Applicable
