Please provide the following contact information:

Name

E-mail

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Home Phone

FAX

URL

What is your preferred method of contact?

What time is the best time to reach you?

Do you have a website plan? Yes No

How many pages will you need or do you think you will need?

Is your site for a business, personal, or non-profit?

Personal Business Non-Profit

Description - a general description of your website purpose (check or mark all that may apply):
a) To provide information
b) To teach
c) To sell products
d) To sell services
e) To provide communication
f) To help gain new business
g) To collect information
h) Other purposes (please state):

Your target audience - a description of who your visitors will be:

What keywords do you think people will type in a search engine to find your products and services?

What regions do you service?

What does your dream site look like?

Admired websites… List sites that you admire and inspire your web design:

Features that you would like to offer:
a) Chat room
b) Message board
c) Articles
d) News
e) Newsletter
f) Shopping cart

Time Frame - When do you expect to have your website completed?:

Do you have a budget? (We can design a plan to fit most budgets)

Yes No

Do you have any financial limitations that could be solved with creating your website in phases?

Yes No

Maintenance - Will you need changes to the website? Yes No

If yes, how often will you need them?

Content - Where will you be getting your content? (Mark all that may apply):

I want suggestions I will provide content I will have a vendor provide content a combination of the above

Images… Where will you be getting images for your website? (Mark all that may apply)

I need suggestions I will be providing them I need suggestions/ I will be providing some

Do you have a logo? Yes No If not, do you have a logo concept in mind? Yes No

Link Popularity… Do you know any website that is related to your theme who might link to you?
Having popular sites link to you that have themes related helps your ranking in some search engines.
Yes No

Do you need hosting?
Yes No

Do you need a domain name?
Yes No

If you require a domain name, what 5 choices would interest you?

Do you need E commerce (shopping enabled website):
Yes No

If you need E commerce:

Along with a website and hosting, the elements needed for an e commerce enabled website are:

a) A way to accept payments - This can be done with a few different methods:

1. Merchant Account
2. Check software
3. Paypal or other electronic payment methods

b) A shopping cart for more then one product: this allows for more than one
item to be "placed in the cart".

How many products will you be selling on your website?

Do you currently have any of these services?
Yes No I don't know

If so please list the services you already have: