Complete as much of the form below as possible and one of our consultants will contact you with an estimate for Custom Web Site Creation, Marketing Packages, Hosting and E-Commerce Secure Shopping Cart System Solutions.Items Marked with an (*) are mandatory, but the more you fill out the more accurate the quote will be.

required fields
Company Information
Company
Address 1 Address 2
City State (required only for US)
Zip Code
Country

Telephone/E-mail Information
Current E-mail Phone
Alternate Phone Fax

Contact Information
First Name Last Name
Best time to call
Telephone Number
(if different from above)

Click here to apply for a Credit Card Merchant Account

Type of service(s) your are interested in receiving information about:
Web Site Design Marketing
Hosting E-Commerce
Digital Photography Credit Card Merchant Account
Printed Advertising Authorize Net Gateway
Custom Scripts Password Protection
Custom Forms Multi-Media Presentations
Database(s) Easy Access for Client to update
Consulting Financing

General Information to help determine a final cost for your web site project.
What is the budget or budget range for this project? $
Does this amount include a marketing budget?
Will this site require an E-Commerce Solution?
If Yes, Do you have a credit card merchant account?
If Yes, aprox. how many products do you have to sell?
If Yes, will you require any digital product photography?

How will you be marketing this site? (Mark all that apply)
You May make multiple selections
by holding down the CTRL key on your
keyboard while clicking on your selection.

Will you require creation of company Logos, etc.?
Are you interested in a multi-media presentation?
Favorite or Company Colors:
Type Of Look Desired:

Purpose and Goals
* Describe the main purpose of this site. Also, list your company's expectations and goals from this site.

Describe any special requirements
you have for the site.

Hosting
Will we host and maintain this site?
Yes No
My domain name is already registered
Yes No
My domain name is currently hosted by
I need a domain name; I would like: (1st choice)
(2nd choice)
(3rd choice)
I would like my domain hosted by

Company domain is registered with


List your competitors websites. What do you like about them?
Also, Describe how your company is different than the competitor:
Competitor 1
Competitor 2
Competitor 3
Reasons

Overall favorite website, for whatever reason. Describe why you like it:
Favorite

Reasons


Additional Information
Reason for contacting us
Additional Comments

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