To receive a free web site design quote, please
fill out all of the information below. The fields marked with
"*" are mandatory.
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| First Name*: |
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| Last Name*: |
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| Email Address*: |
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| City: |
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| State: |
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| Country: |
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| Phone: |
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| Website budget*: |
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| Do you have a current website?* |
Yes
No |
| If you have, please specify its address: |
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| Do you have an idea on how many pages you want
the site to be? |
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| Will you be supplying the text for the site? |
Yes
No |
| Will you be supplying graphics for the site? |
Yes
No |
| Will you need realtime secure order forms on the
site? |
Yes
No |
| Do you currently have credit card merchant accounts? |
Yes
No |
| What is your time frame for web site design/redesign? |
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| Please provide a description of your project.* |
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| Does your company have a logo? |
Yes
No |
| Samples URLs you like*: |
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| Sample URLs of competitors*: |
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| Web Site Add-ons: |
E-Commerce |
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Flash technology |
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Streaming |
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Web Based Tools |
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Online Forms |
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Database Connectivity |
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Video Conferencing |
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Chatroom(s) |
| Please specify how you found our site: |
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| Other: |
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The information will be carefully reviewed by our staff. You
should receive word back shortly.
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