*Company Name:
*Contact Name and Title:
Address:
City:
State:
Zip Code:
*Phone:
FAX:
*Email:
Do you currently have a website?
Yes
No
Domain Name (URL) if yes Or Preferred URL if no:
Products or Services Offered:
How long have you had website:
Who is your current web host:
Who controls your current domain:
Do you have the access codes to the server:
Yes
No
Would your current domain need to be moved to another server:
Yes
No Don't Know
How long (# of pages) is your site or do you anticipate your site to be:
Has your website been successful:
Yes
No Don't have a website
What do you consider successful:
Do you have knowledge of (check all that apply):
HTML
Word Processor
Spread Sheets
Other Advanced Programs
Will you participate in the development:
Yes
No
How much and what type of participation will you provide:
Do you have an outline, storyboard for your site:
Yes
No
What is your preferred color scheme:
Background:
Foreground:
What graphic style do you envision for your site:
Select a style
Colorful
Bold
Conservative
Playful
Retro/Modern
Industrial
Financial
Western
Cultural theme
Other
E-Commerce
Will you sell products or services online:
Products
Services
Please describe products or services for sale:
How many products do you/will you have for sale:
Describe any categories or types for your products:
Describe the services for sale:
Do you require a shopping cart system:
Yes
No
Do you have an active Merchant Account (Visa, M/C, Amx, etc.):
Yes
No
Do you have or require a subscription service (Do you charge monthly, weekly, or yearly?):
Yes
No
Will you need to integrate with your sales or marketing departments:
Yes
No
Will you need automatic responses, fulfillment:
Yes
No
Explain responses needed:
Will you need a database:
Yes
No
Will you need inventory control:
Yes
No
General Information
Do you require extended logs to track your visitors keywords:
Yes
No
If you require media elements, select which ones you would like to have:
Audio Video
Real Audio/Video Quick Time
Flash Live Motion
Other
Will you need E-mail boxes @yourdomain.com:
Yes
No How Many:
Special Needs Please describe any special needs you may have (i.e. secure domains, browser access, large mailing list programs, etc.):
Will you need a chat room or message board:
Yes
No
Who will provide the media or graphics elements:
What level of daily or periodic updates will you require:
If budget is a consideration, please explain:
Please write a brief table of contents for the major areas or topics of the website or provide an outline or story board:
Other Comments: