* Name
Title
- Select a Title -
Owner/Proprietor
CEO/President
Vice President
Manager
Employee
Other
* Email Address
* Phone
Company
Website URL (if any)
Type of Business
- Select type -
Manufacturing/Design
Insurance/financial services
Real Estate/Mortgage
Health/Medical/Pharmaceutical
Wholesale/Distributor
Media/Marketing
Travel/Hospitality
Retailer
Business Services
Other
What services are you interested in?
Designing a New Website.
Maintenance of an Existing Site
Building a Custom Online Store
Internovations QuickStore® Solution
Website Hosting
Email Boxes
Email Blasting
Email Blast Design
Search Engine Optimization
Other (please specify):
How many web pages
do you anticipate?
- Select number -
not sure
1-5 pages
6-10 pages
11-25 pages
26-39 pages
40-59 pages
60-99 pages
100+ pages
Describe any features
you'd like to include in your website. Please be as specifc as possible.
How often would you like
your website updated?
- Select frequency -
Daily
Weekly
Monthly
Very rarely
Who will update your website?
n/a
My company
An outside firm
Outide Firm and My Company
Not sure
Who will host your site?
n/a
My company
An outside firm
Not sure
What
is your total estimated
budget for this project?
- Select budget -
$500-999
$1,000-4,999
$5,000-9,999
$10,000-19,999
$20,000-39,999
$40,000-74,999
$75,000+
When
would you like to get started?
- Select timeframe -
ASAP
Within 1 month
Within 2 months
Not sure
Please
enter your additional comments here.
I
prefer that you
Call me
Email me
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