Contact Us
Full Name:
REQUIRED
Email Address:
REQUIRED
Company Name:
Telephone Number:
(include area code)
Current Website ?:
example: www.mybusiness.com
How Would You Describe Your Business?
----- Your Answer -----
Privately Owned
Self Employed
Small Business
Corporation
Organization
Non Profit
Religous
Communtiy
Other
What Is Your Estimated Time-frame?
----- Your Answer -----
Within Two Weeks
Within One Month
1-2 Months
2-3 Months
3-6 Months
Not Sure
How Would You Describe Your Website?
----- Your Answer -----
Attraction
Business
Community
Education
Government
Non-Profit
Organization
Religous
Resource
Other
Primary Purpose Of Your Website?
----- Your Answer -----
Sell Products
Sell Services
Advertise Business
Provide Information
Other
Estimated Size Of Your Website?
----- Your Answer -----
1 - 3 Page Website
4 - 6 Page Website
7 - 9 Page Website
10 or More Pages
25 or More Pages
50 or More Pages
Not Sure
Will You Need To Register A Domain Name?
Yes
No
Not Sure
Will You Need Access To Update Pages?
Yes
No
Not Sure
Do You Know What You Want In A Website?
Yes
No
Not Sure
Will Your Website Require A Lot Of Pictures?
Yes
No
Not Sure
Will We Host Your Website?
Yes
No
Not Sure
What Is Your Target Audience Area?
----- Your Main Target Area -----
Within Douglas County
Southern Oregon
The State Of Oregon
Western United States
Anywhere In The United States
Anywhere In The World
Not Sure
Other Features of Interest
Company Logo Design and Creation
Business Or Corporate Information
Existing Marketing Literature And Graphics
Periodic Newsletters or Information
Regularly Released Information
Frequently Asked Questions List
Display Inventory Online
Update Inventory Online
Accept Credit Card Payment Online
Accept Orders Using An Email Form
Audio (sound)
Video or Movie Clips
VBScript Or Active X Controls
Animation (animated graphics)
Affiliate Programs
Website GuestBook
Website Calendar
Website Search Engine
Website Chat (online)
Website BBS (bulletin board)
Website Exam or Quiz
Surveys, Polls, Questionnaires
Email Forms (such as this one)
Free For All Links
eMail List Manager
Banner Rotation Program
Custom CGI/Perl Program
Visit Counter Statistics
Other
List the URL for any websites that you consider to be similar to what you need:
( examples: targeting a similar audience, providing a similar product or service, a design or look you like , etc )
