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* are required.
Please feel free to provide as much or as little
information as you like.
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First Name * :
Last Name * :
Daytime Phone Number:
(include area
code)
Email Address *
:
What type of Web site design services are you looking
for?
Design
of a new site
Redesign, repair, addition, or upgrade of an existing
site
Maintenance to an existing site
Other
(please specify):
Do
you want your site to: (check as many as apply)
Inform
people about your business or organization?
Inform
people about a service you provide?
Sell
products?
Provide
product or customer support?
Help
your customers to communicate with you or find your
business?
Any
other purpose? (please specify):
What is the most important action you want your
visitors to do when they come to your site?
(e.g. give you email address, buy something, request
more information, call or email you)
Estimated number of pages?
What kind of materials do you
already have or need created for inclusion on your site?
(check as many as apply)
Do
you already have your own Domain Name registered?
yes
no
don't know
If yes, what is your domain name
(URL)?
Would you like
S ite D irections
to register a domain name for you in your name?
yes
no
don't know
If yes, what name do you have in
mind?
Would you like help with getting a Web site host?
yes
no
don't know
Would you like to learn how to take care of your own web
site?
yes
no
don't know
List 3 web sites that you admire, explain why you like
them, and what aspects you would like to include in your
own site's design
Site 1:
Why do you like this site?
Site 2:
Why do you like this site?
Site 3:
Why do you like this site?
When would you like the project
to start?
Immediately
In
3 or 4 weeks
In
3 or 4 months
Undecided
Please use this space to add your
questions or comments or to provide information you
think would be helpful in describing your project.
How did you hear about
S ite D irections ?
Recommendation/Word
of Mouth
Search
Engine
Web
Designers Directory Site
Link
from another site
Other
What other (please specify):