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* Contact Name:
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Company Name:
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City and State:
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* Phone:
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* Email Address:
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How would you like to
be contacted?
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If you currently have a
website, please
supply the website
address here:
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Yes, I will need a domain name registered.
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Will you need a
domain name
registered for your site
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No, I already have a domain name registered.
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Yes, I need hosting for my website.
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Will you need hosting
for your website?
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No, I already have a hosting provider.
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(Please supply the name/web address of the host)
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* Approximately how many
pages will you need other
than the pages used to
display your products?
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* Approximately how many
products will you need us to
enter during initial
development?
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* Project Description:
Please describe what you
envision for your website.
Also, if you have any specific
requirements, please list
them here.
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* What is your projected
budget for this project.
(Please be realistic here so
that we may better serve you.
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Are there any existing
websites that closely match
the functionality and/or
design style you wish to have
for your site?
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How did you hear about us?
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Do you have any additional
comments and/or
requirements that you feel
may be important?
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Occasionally, our workload is too demanding to take on new projects. If
this is the case, we may opt to share your request with select developers
who may be able to assist you. By submitting this request, you are
acknowledging your understanding and are agreeable with this policy.
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