Contact Information:
Company Name:
Contact Name (Required):
Physical Address:
City:
State:
State
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip:
Phone:
-
Fax:
-
E-mail (Required):
I found you:
Friend
Website (Please list below)
MWDS Client
Family
Stumbled across you
About
your Company:
What industry is your business?
Do you currently have marketing materials?
Yes
No
Who is your target market for this website?
About
the Website:
Do you currently have a website?
Yes
No
If yes, what is the address?
What is your desired completion date
of the website?
What is your purpose for the website?
Site
Layout:
Which pages do you want included on your
site?
Other Pages (please list the names of
these pages):
Total Number of Pages:
What are your color preferences (esp.
what colors are you using in current marketing materials)?
What are your font preferences (Verdana,
Times Roman, Arial, Helvetica, Georgia) ?
Background preferences (solid color,
texture, border, pattern, watermark?)
Do you have your logo in electronic format?
Yes
No
Do you have the content written for the
site?
Yes
No
Do you have the images/graphics you wish
for the site?
Yes
No
Do you want audio or video streaming
on the site?
Audio
Video
Both
Which pages?
What is the overall impression you want
to give your visitors? (High quality merchandise, elegance, sense
of humor/fun, professionalism, etc.)
Hosting
and Domain Names:
Do you have a host selected?
Yes
No
Would you like us to host the site?
Yes
No
Do you have your domain name purchased?
Yes
No
What domain name would you like?
Keywords:
What are some keywords you'd like us
to use when submitting you to the search engines? Try to choose
words that the average joe would type in to look for similar businesses.
Other:
Any other comments/suggestions?