Do you already have a website? 

If Yes, please provide the website address 

If Yes, Do you require a quote for redesign of your website? 

Have you registered domain name/names?  

If Yes, please list the addresses 

If No, please indicate the desired domain name/names 

Select the option that best describes the purpose of your website

Describe the target market of your website?  

Will your company provide most of the textual content? 

Will the graphics be provided by you? e.g. logos and photos  

Do you want pricing for promotion of your website?  

Do you want pricing for ongoing promotion of your site?  

What do you want the site to include ? (Please tick the features/services that you want to be included. Check as many as necessary - do not worry they do not cost much)  

Miscellaneous section: Please provide any other relevant information here. You might include information on the type of products and services you are selling or any other feature you would like to include in the site   

How many pages of information do you expect the website to contain?  

Please provide information on how you wish your site to look. You may provide examples of websites that you like  

Please give an estimated budget for your website. 

Name * 

Companyname  

Email * 

Address  

Phone