Your Information
Fill out as much info as possible below, the more info the better. I'll get back to you within 2 business days via email with a proposal and quote customized to meet your needs perfectly. Call me if you would rather go over your design needs and information by phone at 603.205.5596. Thank you - Jill
Contact Info
Name
*
:
Email
*
:
Phone Number:
Please contact me by:
Email
Phone
The best time to reach me is:
Company Info
Company/Business:
Business Type:
(automotive, salon, school, financial, etc)
Website URL:
(if you already have one)
Site Domain & Hosting
Do you need a domain name (ex: xyz.com)?
No
Yes
If yes, what would you like your domain to be?
(list up to 5: myname.com, company.com, company.net, etc)
Do you need Hosting services?
No
Yes
Not Sure
Site Content
Will you be selling anything online?
No
Yes
Which web pages do you need?
(select all that apply)
Home
About Us
Services
Products
Contact Us
FAQ
Policies
Sitemap
List any other web pages you need:
(menus, pricing, etc)
Your L
ikes & Dislikes
1-3 URL's of competitor's
sites you
like
and why:
(colors, layout, graphics, font, etc)
1-3
URL's of websites
you
don't
like and why:
(colors, layout, graphics, font, etc)
If you have a design in mind, please share here!
Colors:
Graphics/Photos:
(ex: people, landscapes, graphics, abstract, etc):
General Design Layout:
(describe in as much detail as possible)
Do you need any of the following for your site?
Live
Chat service:
(talk in real time to your customers)
No
Yes
Database:
(store your sales leads and customer info when they
submit your forms or contact you on your website)
No
Yes
eSupport (online helpdesk):
(help desk tickets, knowledgebase, etc)
No
Yes
Forum:
No
Yes
Blog:
No
Yes
Photo Gallery:
No
Yes
List any other site needs here:
Do you need SEO, Online Advertising or Marketing Services?
Search Engine Submission:
(Your site is submitted to top
Search Engines and Directories)
No
Yes
Copywriting:
(re-write content around keywords & phrases).
No
Yes
Google & Yahoo Account
(Google & Yahoo advertising account for
pay-per-click sponsored listings)
No
Yes
Email Marketing
(create and send out email campaigns, customers can opt-in and opt-out of subscriptions)
No
Yes
Other Information Needed
When do you need your site completed by?
Do you have an estimated budget for this project?
Any other general questions/comments: