Your Information
*First Name:
*Email:
*Last Name:
City:
Address:
Zip Code:
State:
Telephone:
Company Background
Do you own a domain
name, or need to purchase one?:
need
to purchase one
already
own one
Our budget for this project is:
Please select
< $1,000
$1,000-$2,000
$2,000-$4,000
$4,000-$7,000
$7,000-$10,000
> $10,000
Do you have a web
site already? If so, what is the URL?:
What is your company's name?:
What is your
industry?:
What color scheme would
you like to use throughout your web site?:
What are the links
(categories) you want to use on your web site? Please list them.
For example:
1) About Us
2) Services
3) Directions
4) Careers
5) Contact Us
etc...
Will
you need web site hosting or email for your company/business?
We offer web site hosting and company email starting @ $110.00 for
12 months.
YES
NO
Don't know
Will
your web site need frequent updates?
Your comments or questions
about this project:
How did you hear about us?:
Please select
AskJeeves.com
AOL
AltaVista
Business.com
CNN.com
Dogpile.com
Earthlink
Ebay
Google
InfoSpace
Kanoodle
LookSmart.com
Lycos
MetaCrawler.com
MSN.com
Search.com
Overture.com
WebCrawler.com
Yahoo
____
Friend
Business Associate
Other
If other, where/whom?:
ENTER SECURITY
CODE:
(cASe SenSITivE)