Name
Phone Number
Email Address

Current Set-Up

 
Do you have a domain name? Yes No
If Yes, what is it.
When does it expire?
Who is it registered with?
Do you have the domain name password? (to make changes) Yes No
Do you have a hosting package? Yes No
Is it included with your Internet access? Yes No
When would you like to see your site online?

2 weeks
1 month
3 months

Design Elements

What do you want your website to represent?

Business Card/ Referral

Dynamic, functional (surveys, questionnaires,etc.)

Do you have a corporate logo?

 Yes No
   
Do you have any corporate branding? Yes No
What are your colours?
Name 5 website's that you like.(They do not have to be industry specific.)
 
Thank you for taking the time to complete this form. This will help us provide you with the best solution to your web development needs. If you have any questions please let us know.
 
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Just Perfect Designs
Hand-crafted sterling
silver jewellery.
Gro-Bark
Ontario's major horticultural supply companies.
 
C.F.M.S Online
Largest Fleet Maintenance Seminar in North America
Purplefish Photography
Capturing the poignant moments of life.