ORDER FORM

Your Name:
Company Name:
Phone Number:
Email:
How should we contact you?
What time is best to contact you?
What services are you interested in?
(Select all that apply)
New website design
Website re-design / maintenance
Search Engine Optimization
Computer repairs
Network setups
Installs / upgrades
Graphic Design
   
 
How many pages do you want us to design?
1-5
6-10
11-15
16+
   
 
What is the primary objective of the website? (Click all that apply)
Products and/or Services
Informational / Newsletter
Retail
Introduce our company
Expand our company
Other
   
 
What features would you like introduced to your website?
(Click all that apply)
Ecommerce site (accept credit cards/paypal
Secure website (login/passwords)
Feedback forms
Graphics
Other
   
 
What is you estimated budget?
 
How soon do you require the website to be completed?
 
Additional comments?
   
Information provided in this order form will not be shared with anyone.

 

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