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WEB SITE DESIGN SERVICES

Please complete the following form and pay special attention to the fields marked red.

Your email:

First name:

Last name:

Title:

Company:

Address:

Address:

City:

State:

Zip/Postal code:

Country:

Phone number:

Fax number:

What Web Site Package are you interested in?
Basic Design Packages
Enhanced Design Packages
Premium Design Packages
Custom Design Packages
Web Business Basic
e-Commerce Made Easy! "You Buy It, We’ll Build It"
Web Business Plus
e-Commerce Made Easy! "You Buy It, We’ll Build It"

OTHER SERVICES AND INFORMATION

Have you registered a domain name? Yes No
Will you require web hosting? Yes No

WEB DESIGN
Approximate number of pages in site

Style of site (click all that apply)
Corporate
Clean and Simple
Hi-Tech
Fun/ Colorful
Dark/ Moody

Features you'd like your site to have (click all that apply)
Macromedia Flash
3D Imagery
Java Script or Animated Buttons
Forms
Animations
Sound
E-commerce
E-mail Newsletter
FTP Storage
Other (describe)

Provide the addresses of at least 3 of your favorite
websites that have the look and feel you desire.

Please provide a brief description of what your sites
primary function will be.

PRINT DESIGN

[Logo Design]
[Stationery Package]
[Brochure]
Other

Provide a brief description of the print or design job

WEB MARKETING

Provide a brief explanation of your marketing needs.

OTHER SERVICE

Provide a brief explanation of what you need.

When would you like to start your web site?
Enter Date

Please select a category that best describes your product or service:

Best Day to Call:

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Markets serviced:

Comments:

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