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Company Details
Company Name
*
Tag Line or Slogan
*
Type of Business
*
Services You Offer
Your Target Market
Your Primary Reason for having a Website
What is Your Approximate Budget for This Project?
Not Sure
< $500
< $1000
$1K to $2K
$2k to $5k
> $5000
The Timeframe for Your Project?
Please make a selection:
Need to start ASAP
Starting within a month
Starting 1-3 months
Starting 3-6 months
Starting 6-12 months
Gathering information - no timeframe
Website Details
Current Website If Any
Do you have a logo?
YES
NO
List 3 URLs (web addresses) of sites that represent the style or quality you are looking for in your own site. – consider layout, colors, navigation graphics, font/print, etc.
Color Preferences
Comments/Instructions
Contact Details
Contact Name
*
E-mail
*
Phone
*
Where did you hear about us?
Please Select
Search Engine
Yellow Pages
Direct Mail
Referral
Current Client
TV Ad
Others
*
= required
Image Verification
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