| Contact Name* |
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Company* |
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| Country |
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Phone* |
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| Address1* |
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Address2 |
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| City* |
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State* |
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| Zip* |
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Email* |
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| Website address/ desired Domain(s)* |
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Any other Decision maker* |
Yes
No
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| What Industry?* |
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Do you have a timeframe to get this site online* |
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| Purpose of this site?* |
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Describe your Business* |
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| What will make this site a success?* |
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Target Market* |
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| WEB COMPONENTS |
Please list the pages*: |
| Page Name |
Describe content |
Is content ready? |
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Add Page |
Remove Page
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| List Websites you like?* |
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Websites of your competitors?* |
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| Do you have images file ready?* |
Yes
No | Do you need artwork created?* |
Yes
No |
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| Describe the site color scheme* |
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What kind of images?* |
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SITE FUNCTIONALITY: |
| Is this a Ecommerce Site?*
Yes
No |
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| Details of what you are selling |
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Are you selling product/services? |
Yes
No |
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Do you need to track inventory? |
Do you need to track customers/ build a database of them? |
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| Will you want to do mass email marketing mailings? |
Are you selling anything on a subscription basis? |
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SPECIAL FEATURES: |
| Will you need Audio?* |
Yes
No |
Will you need video?* |
Yes
No |
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| If yes Are the Audio files ready? |
Yes
No |
Is the video file ready? |
Yes
No |
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| * Security Code: |
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