Please complete, as best as possible, all of the information on the form below in order for us to understand you custom Web site development needs. The more information you complete, the more accurate the quote.
Contact Name [First & Last ]:
Cell or Other Phone:
May we contact you by phone if we have questions regarding your request?:
When is the best time to contact you?:
How would you like to receive your quote?:
By US Mail
Tell us about your business
Type of Business:
Please describe your business with details as much as possible:
What is your budget for this project?
Requirements For Site
Do you have a Domain Name registered? (e.g. www.name.com)
If you do not have a Domain Name registered would you like us to register one for you?
Do you require Web hosting services for your web site?
Do you require Webmaster maintenance services for your site after it is created?
If you answered "Yes", please enter your Domain Name below:
How many pages will your Web site consist of?:
Are you interested in having graphics images or photographs on your site if yes how many?:
Would you like a form(s) on your site? (e.g. contact / feedback form similar to the form you are using to request a quote):
If you answered yes, how many forms would you like:
Would you like e-mail accounts for your Web site?
If you would like e-mail accounts, how many accounts do you need?
Would you like to accept credit cards on your site?: (Note: eCommerce Merchant site prices begin at approximately $1000.00 and monthly hosting costs are much higher than non-Merchant sites)
Do you currently accept credit cards in your business?:
Do you currently have a Merchant Account from a bank?:
How would you be supplying the text content for your site?:
Electronic Format (i.e word processing files)
Hardcopies (i.e. you would require us to type all the text
How would you be supplying the graphic content (i.e. your logo, pictures, etc.) for your site?:
You would require us to scan your images or photographs
After your Web site has been completed, would you like us to submit your Web site information
Additional information or examples of Web sites( URL's) you like:
Please tell us how you found our Web site: