| Contact Information |
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Customer Name: |
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Company Name: |
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Email Address: |
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What is the best time to reach you ? |
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And at what number ? |
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Alternate number ? |
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| Web Hosting Experience |
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Do you currently have a web site ? |
Yes No |
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If so what is your URL ? |
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Are you happy with your site ? |
Yes No |
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What would you do different ? |
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What will the nature of your web site be (ex: Business, non-profit, personal, etc.) ? |
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When do you need the web site to be completed -- Timeframe (ASAP, 3 weeks, 3 months, etc.) ? |
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Did you have a budget in mind, if so, how much ? |
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What are your primary objectives ? |
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a. Promote Product/Event by providing Info |
Yes No |
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b. Gain new customers by marketing/advertising on Web |
Yes No |
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c. Customer Service-provide info to existing customers |
Yes No |
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d. Sell Products on-line: HOW ? |
Provide contact info, where to call, fax, email, or send $ order
Submit form sent via email using CGI
Secure order forms / shopping cart ordering |
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Will you be supplying Logo and/or graphics ? |
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Do you want any special effects; animation, moving graphics, mouse-overs (Javascript) ? |
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Do you want any interactive features -- i.e., chatroom, email discussion, auto respond, webring... ? |
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Do you want your site promoted to search engines, industry specific directories, indexes, and or award sites ? |
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How often will you need to add, change, update, enhance the information ? |
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