About Us
Name
Company Name:
Email
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Street
Address 2:
City
State
Zip:
Phone:
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Our company serves these areas: Please list geographical locations.
Our customers base consists of: Please list. (Ex: Professionals, Soccer Moms, Looking for xyz product or service)
Our company's main product line or service. Please list. (Ex: We sell widgets. --- Plumbing --- Home Repair --- etc.)
Website Usage
Purpose of web page: Check all that apply:
To attract new customers.
To inform my current customers of sales, new services, etc.
As a sales tool (An online advertisement showing name, product, location etc.)
Our company would like a catalog on our site, with a merchant account.
Our company would like to take surveys online.
We would like to add a blog to the site.
We will write it ourselves.
We need photos taken.
We will supply the photos.
The content needs to be written.
Our company needs a logo designed.
The site will be optimized.
The site will need to be maintained.
Monthly
Weekly
Daily
Other (periodically updated)
I expect the website to be published
days from date of contract.
Color preferences. Please indicate here.
Websites Hosting
I need a web host
I have chosen a name.
Our site name has been registered with
I have a current website,
The site needs to be updated.
Instructions or comments:
These sites are for reference:
Special Instructions: