Thank you for your interest in our web hosting
and website design company.
In order to serve you better, we need a bit of information, about your ideas,
for your future web site. Please answer a few questions for our web host
company web
designer. We will contact you with pricing and options for your specific web design needs.
*Your email Address?
*Confirm your email
*Your first name:
*Your last or family name:
*Your Street Address:
*City
What Domain Name or Names will you
be using if chosen? (1 per line please)
or
Do you need assistance choosing a domain name?
(Choose One)
Yes
No
If so, what kind of names or themes do you have in mind?
What is or will be the purpose of your site?
How many pages do you anticipate
you will be using?
(choose anticipated pages)
over 600
451-600
301-450
201-300
151-200
100-150
76-100
51-75
25-50
13-24
1-12
Is this for a non-profit organization?
(Choose One)
Yes
No
Will you need a shopping cart?
(Choose One)
Yes
Possibly
No
Do you have your own Logo?
(Choose One)
Yes
Not Sure
No, Please Make Us One
No
Do you have product images, or other images?
(You may choose more than one option, by holding down the ctrl key while
making your selection.)
(choose one or more)
Yes, Products
Yes, Our Logo
Yes, Other Than Products
Yes, Products And Other Images
No
Please check all of the following the following services you would like on
your site.
What is your web advertising and
web project budget?
(choose budget limitations)
OVER $5500
$4501-$5500
$3501-$4500
$3001-$3500
$2001-$3000
$1501-$2000
$1001-$1500
$500-$1000
UNDER $500
Will you need web site hosting or
web page hosting for your site?
(Choose One)
Yes
Not Sure, Please Advise Us
No
See our
web
hosting services plan comparison for explanation of our web host
services packages.
*Your Phone
Any other specific instructions? (Specific
colors, styles, layout ideas or other questions or descriptions.)
policies