WEB DESIGN INQUIRY FORM

Basic Information

1 Name*

3 Website

2 Email*

4 Type of Site You Want
BrochurePhoto GalleryBasic e-commerceAdvanced e-commerceNot sure

Design & Style

1 Briefly describe what you have in mind for your site

2 List up to 5 sites that look and/or function the way you want your own site to

Site

Reason

Timeframe & Budget

1 When do you need the site by?
I needed this yesterdayI need it in about 1 monthI need it in about 3 monthsI need it in about 6 months

3 Budget
Under $1,000$1,000 - $3,000$3,000 - $5,000$5,000 - $10,000$10,000 - $20,000Over $20,000

2 Images & Site Text
I have all the images and text I need for my siteI don't have the images and text yet, but I will soonI will need your help gathering images and text

4 Interested in payment plans?
YesNo

Additional Comments