Request a Business Website

Filling out this form will help me understand what you are looking for in a website design.

Business or Organization Details

Full Name:
Business or Organization Name:
Street Address:
City and State:
Zip Code:	(5 digits)
Phone Number:
Fax Number:
Email Address:
Do you have a company logo?	Yes No
If no, do you need one designed?	Yes No
What is the nature of your business or organization? Briefly describe your products or services.
Who is your target market? Who are you hoping to reach with your site?

Do you have an existing website?	Yes No
If yes, what is the URL?
What type of look are you looking for?	clean high-tech conservative warm flashy natural other
List 3 URLs of quality sites that you like the look of?
List the major topics you would like to have on your website:
Do you have any images you would like used in the website design?	Yes No
If no, what type of imagery do you feel would be suitable for you website?