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Request a Quote

Our Web Design Consultation is Free!

  

By filling out the short form below you will help us determine your web site needs, or you may call us with this information.

The questions below are only a guide. Fill out as much or as little as you want and include any additional information in the comments area. When you are finished, Click the submit button at the bottom of the form. We will contact you for a free web design consultation as soon as we can!

Business Information:

Your Name  Your Company's Name

City  State   Email Address    

Phone      Best time to reach you

How did you find us?

Background & Objectives:

What does your organization or business do?

What are your goals for the website?     

Provide Information about your business or organization.

 

Promote Services

 

Sell Products

 

Showcase Your Work

 

Marketing Tool to Attract New Customers

 

Enhance Your Business Image

 

Communicate with Customers, E-Newsletters, etc.

 

Provide Downloadable documents (forms, manuals, menus etc)

 

Provide Employment Information and Job Opportunities

 

Other

 

Other

 

Other


Services Required:

Design New Site - Aprox number of pages

 

Re-Design Your Current Site -
      Current Site Address:
http://www

Domain Name Registration & Hosting:

Do you need a Domain Name Registered?

Yes No, my domain name is:
              www.

Will you need web site hosting?

Yes No Don't Know

Other Web Design Services:

E-Commerce:

Yes

        Do you accept credit cards now? yes No

      Miva Online Shopping Cart

      Payments with Paypal

      Secure Online Order Form

      Not sure what type of E-Commerce I need

Interactive Forms:

Yes

Photo Gallery or Slide Show:

Yes

 

 

 

Web Site Look & Feel:

List websites that you like (if any) and those that are similar to the type of design you want?

What colors, themes, designs, etc. do you like?

Do you have a logo to coordinate your site with?

Yes No

Other Information:

Do you have a deadline or time frame when the site must be completed?

If yes, when:

Other Comments or Questions:


          

Note: We value your privacy.
We will never share or sell any of the information that you provide to us.


 

Copyright 2001-2006 All Rights Reserved
Oregon Web Site Design by 101 Web Builders