New Site Questionnaire
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- required
Privacy Statement
This form is not a contract. It is used for initial information collection only.
The information collected may subsequently be used to develop a bilateral contract that will satisfy both parties.
Information gained from this form submission is for the sole purpose above and will not be given to third parties without prior consent.
Basic information about you
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Your full name:
Example: William F. Smith Jr.
Preferred short name:
Example: Bill Jr
Your company name:
Example: New Web Site Beginnings, LLC
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Contact preferences:
Phone
E-mail
USPS Mail
How would you prefer to be contacted?
According to your preference choices above, please provide us with the information necessary to contact you.
Primary North
American phone
number:
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-
x
Example: 555 555 5555 (extension optional)
International phone
number:
If other than a North American phone number.
Example: +55 5555 5555
Your email address:
Example: you@yourmailserver.com
Your mailing address:
(chars left:
163
)
Name Address1 Address 2 City, ST Zip
Please replace the pre-filled values with your actual mailing address.
Basic information about your web hosting status
Do you have a currently hosted web site?
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Current web site:
Yes
No
Please choose Yes or No.
If you chose "Yes" above, please supply us with the URL to your current web site.
Current web site
address:
Example: http://www.yourcurrentsite.com
If you haven't purchased the domain name, have you chosen one to use?
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Current domain name:
Yes
No
Please choose Yes or No.
If you chose "Yes" above, please describe it.
Your chosen domain
name:
Example: my_chosen_domain_name.com
If you chose "No"please describe your choices below.
We will research and confirm the domain name availability.
Domain name choices:
New:
Please add from 1 to 6 domain names you would like.
Example: mysite.com
Basic information about developing your web site
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Target audience:
What is your primary target audience?
Example: Home buyers
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The primary focus of
your web site:
Company information
Entertainment
Sales
Services
Information gathering
Information distribution
Professional
Personal
Other:
Please choose the PRIMARY focus of your web site.
Please, only 1 choice.
This section will give us an idea of the type of pages your web site will contain.
Choose as many as you feel is appropriate.
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Page choices:
Home page
Contact US
Privacy policy
FAQ's
Products
Services
Calendar
Newsletter
Blog / Forum
Location map
User interaction
Restricted access
Other:
Choose all that apply.
Please list any information you wish to collect via online forms such as contact information, questions, opinions, polls, contests, etc.
Data collection:
New:
Please add from 1 to 10 data collection forms.
Example: This form you're currently filling out.
Please supply us with any additional information you feel is appropriate toward determining the cost and project completion time of designing your web site.
Additional
information:
(chars left:
1000
)
Comment field limited to a maximum of 1000 characters.
Thank you for your patience. We will process and reply to this submission as soon as possible.
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