Web
Site Design and/or Application Quote
Depending on the scope and details
of your project we may contact you
by phone or email.
Your name:
Business name:
Type of Business
City
State/Province
Country
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Barbuda
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Botswana
Brazil
British Virgin isl.
Brunei
Bulgaria
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Rep.
Chad
Channel Islands
Chile
China
Colombia
Congo
Cook Islands
Costa Rica
Croatia
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faeroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Great Britain
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Irak
Iran
Ireland
Ireland, Northern
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kuwait
Kyrgyzstan
Latvia
Lebanon
Liberia
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar/Burma
Namibia
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Rwanda
Saba
Saipan
Saudi Arabia
Scotland
Senegal
Seychelles
Sierra Leone
Singapore
Slovak Republic
Slovenia
South Africa
South Korea
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tanzania
Thailand
Togo
Trinidad-Tobago
Tunisia
Turkey
Turkmenistan
United Arab Emirates
U.S. Virgin Islands
U.S.A.
Uganda
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wales
Yemen
Zaire
Zambia
Zimbabwe
Email
Phone Number
Cell Phone (optional)
Fax Number
Best way to contact you:
select one
phone
cell phone
fax
Email
Size of your
company
Small
Medium
Large
Main Direction of Web
Site / Application
Project
options:
For
what purpose is your organization
intending to develop a website?
Design and Development
Specifics
Please
list any ideas or preferences you
have for design or style:
Approximately
how many pages will you need
developed for your website?
Please
Select
1-5 Pages
6-10 Pages
10-20 Pages
20 Plus
What primary colors
would you like for your website
What
other sites do you like that are
similar to the type of design you
want?
1.
2.
3.
4.
What do
you like about them?
What
do you NOT want on your site?
What
graphics, photos and other art
do you have?
What
graphics, photos and other art
do you need designed?
If
you would like to add any extra
functions please check them below:
Sign up / Login
Feature
Blog
Public Chat
Newsletter
Chat with Sales Representative
Photo Gallery
Opinion Poll
Shopping Cart
Guestbook
SSL Encryption
Search Box
Member Only Access
Forum / Discussion Board
Secure e-mail
Link Indexing Technology
Secure Reservation or Contact
form
Reservation System
Content Management System
(CMS)
Inventory Control
Document Management
Document Management
Accounting
Other
Other
Other
Other
A Little about You
Which 2 are most
important to you? Please ONLY select
2 of the 3 options below
Time
Cost
Quality
Multimedia / 3D
Animation
Hosting
Internet Marketing
( Search Engine Optimization)
About your Business
Please
give a brief description about
your business
What
are your long and short-term goals
as a company? goals for the website?
Describe
the Product(s) and/or the Service(s)
you offer?
What are the
most frequently asked questions about
your product/service?
What
is your target audience?
Accessibility
Would you like
your web site accessible by:
Devices (PDA's, Phones etc.)
the visually impaired
Other special requirements:
Ongoing Website
Maintenance ( Web Mastering once
site is completed )
or (choose which
one best describes your current and/or
potential target audience)
Start / Completion
Date
Preferred
Start Date
Please
Select One
Immediately
1
week
2
weeks
2-4
weeks
1-2
months
3-4
months
Not
sure
Projected
Deadline Date
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
January
February
March
April
May
June
July
August
September
October
November
December
2005
2006
2007
2008
2009
Print Services (
coordinate your website and print
materials)
Please let us know how
you heard of us: