Name:
E-mail:
Company:
Phone:
Fax:
Address:
City:
State:
Zip Code:
Country:
Is your domain name already registered? Yes No
How many pages do you think your site will be?
What is the main goal of your web site or development project?
Please describe in detail the objectives of your web site and exactly what you want the web site to be able to do. If you want a shopping cart with secure online ordering, please indicate that here. If you want a directory style site similar to Yahoo, indicate that. Give us enough information to know exactly what your needs are.
What is your price range?
A word on pricing
Purchasing a web site is somewhat similar to purchasing a car. You can buy a car for $10,000 or $25,000 - the difference in price is one of performance and options. We ask for a price range simply to find out what type of web site you are requesting based on the level of functionality. A 5 page Informational only web site can start at $1,000, but a web site that is completely e-commerce enabled, with real-time credit card processing, a shopping cart, and a separate technical specs database system will be more in the $5,000 - $10,000 (or more) range. And there are many variations in between.
Because we create custom, fully integrated solutions for our clients, pricing is done individually for each client based on specific needs and goals.
Please indicate the size of your business: 
Please select category that describes your business: 
Do you have 'web ready' pictures, logos, or graphics ? (i.e. in GIF or JPG format)      Yes  No 
Do you have high quality brochures or Photos you would want scanned?       Yes  No 
Do you have text written for use on a web site in PC format?
      Yes  No 
Please provide us the full URLs of any sites that you think are good models of what you are looking for: 
URL 1
URL 2
URL 3
URL 4
Please indicate why you chose these sites -- what aspects of these sites do you like:
Please indicate your projected time frame for having a site online: 
Who may we thank for referring you?
Any other Comments?
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