Company Name:
Main Contact:
E-mail:
Phone Number:
Address:
City: State: Zip:

Which of the following describes your needs?

Original Site Design
Update Existing Site
Redesign Existing Site
Maintenance/Updating Services (How often? )

Purpose for site (Sell product(s), informative…)

What audience are you targeting? (Who will most likely visit your site?):

How many pages do you anticipate needing?

Which of the following elements will you need in your site?

Printable pages (Adobe PDF files…) (explain below)
Motion/Sound (explain below)
Original graphics (logo creation…) (explain below)
Forms for gathering information (explain below)
Integration with a database (explain below)
E-commerce (shopping cart) How many items?

Use this space to explain your needs checked above.

Deadline for completion:

Have you secured a Domain name? No Yes

Have you chosen a company to host your site? No Yes

List existing sites that have a similar look and feel that you are wanting to achieve in your site:

	URL (Internet Address)	What do you like about this site? (colors used, layout, navigation…)