Name
*
First Name
Last Name
Email Address
*
Phone Number
*
(###)
###
####
What services do you need?
*
Web Site Design & Development
Corporate Branding
Logo Design
Business Card Design
Flyer/Brochures
Web Site Maintenance
eCommerce Development
Redesign of Current Site
Content Writing/Management
Mobile App Development
SEO Evaluation
Social Media Management
What is your budget?
Not sure
Less than $1,000
$2,000
$3,500
$5,000
$10,000
Other
Ideally, when would you like your project(s) completed?
MM
DD
YYYY
Describe the nature of your business.
List the services that your company provides.
Describe your target audience (average age, special interests, income level, education level, etc).
Do you have a domain name registered?
Yes
No
Do you have hosting?
Yes
No
Do you currently have a logo or corporate colors?
Yes
No
List some sites you admire or would like to emulate.
List some sites that you do not like. Explain
What is the website's main purpose?
To sell products
To promote services
To collect email addresses
To build a brand / community
What is the desired outcome from a visitor arriving at the website?
To leave an email address
To make a purchase
To contact you
To fill out a form
Other
Do you want any of the following? (There is space at the end of the form for other requirements).
Blog
Social sharing icons
Links to social profiles
Contact form
Email signup form / ability to collect email addresses
Ability to sell digital products
Ability to select physical products
Will this be a new site design or redesign of your existing site?
Yes
No
How many pages do you anticipate your site will have?
Do you have content for your website?
Yes
No
Are you going to be accepting credit cards?
Yes
No
If so, do you have a merchant account?
Yes
No
How many products and/or services do you plan to sell?
Would you be interested in having us do updates and maintenance to your website?
Yes
No
How often would you require updates?
Daily
Weekly
Monthly
Quarterly
Other
Do you require us to train your employees for updates?
Yes
No
Additional Notes: