Company
Name:
Street
Address (optional):
State/Province
& Zip/Postal Code:
Country:
UNITED STATES
UNITED STATES
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA AND HERZEGOWINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
COOK ISLANDS
COSTA RICA
COTE D'IVOIRE
CROATIA (local name: Hrvatska)
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
EAST TIMOR
ECUADOR
EGYPT
EL SALVADOR
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ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRANCE, METROPOLITAN
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
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GREECE
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GRENADA
GUADELOUPE
GUAM
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GUINEA-BISSAU
GUYANA
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HEARD AND MC DONALD ISLANDS
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ISRAEL
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MARTINIQUE
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MOLDOVA
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MOZAMBIQUE
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
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NIGER
NIGERIA
NIUE
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NORWAY
OMAN
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PANAMA
PAPUA NEW GUINEA
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PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SPAIN
SRI LANKA
ST. HELENA
ST. PIERRE AND MIQUELON
SURINAME
SVALBARD AND JAN MAYEN ISLANDS
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
TANZANIA OF
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
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TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
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UNITED KINGDOM
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VIET NAM
VIRGIN ISLANDS (BRITISH)
VIRGIN ISLANDS (U.S.)
WALLIS AND FUTUNA ISLANDS
WESTERN SAHARA
YEMEN
ZAMBIA
ZIMBABWE
Your
Name:
Title:
E-mail:
(enter valid email , on
this email you will receive your quote)
Phone:
Area
Code (
)
Best
Time to Call:
Morning
Afternoon
Evening
Contact
Me Via:
Phone
Email
What
design and/or marketing services do you want?
New site
Re-design of existing site
E-commerce solution
Web programming/database development
Logo and/or corporate identity
Addition/extension to existing site
Individual elements (navigation, footer, header, etc.)
Multimedia presentation
Market and promote site
Other (Please Specify)
What are the goals for your web site?
What other sites do you like that are similar to
the type of design you want?
What do you like about them? What don't you want in your site design?
Have you registered a domain name?
Yes
No
Not sure
If
YES, what is your domain:
If
you have no domain, please list any possible domain names you would
like for us to check for availability
1.
2.
3.
Purpose of your site:
Sell products/services online. Approximate #
Marketing tool to get new customers/clients
Information resource for current customers
Provide customer service.What type of service?
What
is the nature of your business?
Do
you accept credit cards?
Yes
No
We would like to accept cards
What
e-commerce services do you want?
Shopping Cart for approx. (#)
products/services
Site that uses information from our database.
What
type of database do you have?
Bulletin board/forum for surfers to post messages
Opt-in Email newsletter or ezine
Form for surfers to enter information for data gathering
Site that can be frequently updated by our company
How
frequently?
Site that surfer can search internally
Surfers can download software or other files
Visually
what kind of site do you want?
Simple, streamlined site
Complex, busy site
Serious, responsible, stable personality
Exciting, dynamic, progressive personality
Photos
Clip art, static graphics
Moving graphics, animation (e.g., Flash)
Approximately how many photos/graphics
per page:
What graphics, photos and other art do you already
have?
What art do you need designed? Do you need a logo designed?
Is the text already written?
If yes, can you provide it as a txt file or similar format?
If no, will you write the text or will we write it?
More information about the design services you
want:
What promotion services would you like?
Optimize pages so good indexing by engines
Submit site to Free engines and directories
Recommend Paid submission and Pay-per-click programs
Improve Link Popularity
What other marketing services would you like?
How do you measure marketing success?
What is your Design budget in Canadian dollars?
Under $500
$500 to $1000
$1000 to $3000
$3000 to $5000
$5000 to $10,000
$10,000 to $20,000
Greater than $20,000
Or fill in budget $:
What is your Promotion budget in US Dollars?
Do you have a deadline when the site must be completed?
Yes
No
If yes, when:
How would you like to receive your quote?
Microsoft Word attachment to e-mail
HTML E-mail
Non-HTML E-mail
Questions
or other information we may need: