Name *

Email Address *

Company Name

Tell us what your company does

I want this site because: I want this site because: I need to build awareness for my brand I need to offer a contact point for my clients I need my company to have a better image online I need to sell my product or service through my site I need it to build customer loyalty I need to reach people in many languages I need somewhere to promote my latest product / service I have my own reasons

My clients come to me because My clients come to me because I offer excellent service I have the best products on the market I have the best prices on the market Other

My site will be built to target (age): My site will be built to target (age): Kids and teens People in their 20s People in their 30s People in their 40s People in their 50s Senior citizens I don't know

My site will be built to target (gender) My site will be built to target (gender) Males Females I don't know

Do you have your own domain name? * Do you have your own domain name? * Yes No I don't know

Do you have web host? * Do you have web host? * Yes No I don't know

Do have content for the website? Do have content for the website? Yes No

Do you need our help with website content (text and images)? Do you need our help with website content (text and images)? No, I do not need your help with content Yes, I need your help with content I need your help only with images I need your help only with text

Does your company have a logo/established image & branding guidelines (e.g. fonts, colour schemes etc)? Does your company have a logo/established image & branding guidelines (e.g. fonts, colour schemes etc)? Yes No

What are your branding guidelines (fonts, colour schemes etc)?

Do you need us to create logo for you? Do you need us to create logo for you? Yes No

We want the following special features to be included in our new website We want the following special features to be included in our new website Search functionality Blog module Image gallery Image slider Video streaming Newsletter / email sign-up forms with appropriate calls to action Uploads / downloads Customer login An online store / shopping cart Online payment gateway Other features I am not sure

Do you want to update website by yourself? * Do you want to update website by yourself? * Yes No I am not sure

Web pages needed?

What’s your deadline for this project?

What’s your budget for this project?

Is there anything you’d like to tell us?