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   Contact Information  
 

Name:

  

Email (Required):
 
 General Information  
 

Purpose of Website:

 What is the primary goal of your website?
 

 

Target Audience:

 Who do you hope to attract to your website?
 

 

Look and Feel of your website (Please type and web address of websites that you like.
(For example:  www.microsoft.com - the colors and navigation structure)
 

 

If your website will have any competitors, please type their web addresses below.
 

 
   
 
 Specific Information  
 

Number of pages:
(approximate)

 Include Forms:
(This quote is a form)		 Quantity:
 
 
Type of Form:
(Check all that apply)		 Feedback: Info Request: Other:
 
 
Logo to be designed: Custom Graphics: Pictures/Drawings:
 
 
Newsletter Designed: Custom Advertisements: Pop-Ups
 
 
Domain name Requested:
(www.yourdomain.com)

Web Hosting Needed:

 
 
Special Instructions, Comments, Etc.

 
 
 
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