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Your Name (required)

Your Email (required)

Phone Number (required)

Company Name:

Website URL (ie www.site.com):

Position/Title:

—Please choose an option—President/CEOOwnerVice PresidentCTOCFOCOOPartnerDirectorOther

How many people are employed at your company?

—Please choose an option—1-55-2525-5050-100100-250Over 250

How did you hear about us?

—Please choose an option—Personal Referral (Human)Social Networks (Google+, Facebook, Twitter, LinkedIn)Search Engines (Bing, Google, Yahoo, etc.)Our WebsiteReferral WebsiteFlyerPrint Publication

What type of work are you seeking? (Select all that apply)

Brand new websiteRedesign of current websiteMarketing and promotion of current websiteAdd-ons to current website (such as video, text content, e-commerce, etc.)Other

Why do you need this work performed? (Select all that apply)

I have no website and need a presence onlineMy current website needs e-commerceMy current website needs general updatingI am looking to add content to my websiteMy current website is old. It needs to be updated with newer technologyMy current website is broken. I need a new one!

Please describe your company, line of business, or organization in a few sentences.

What is your deadline for completing the work to be done?

—Please choose an option—Within a few weeks from nowWithin a month from nowWithin three months from nowWithin six months from nowWithin one yearNo deadline. Whenever it's completed.

What makes your company (products/services) better than your competition?(Select all that apply)
We offer a superior product(s)/service(s)We offer the best customer/technical supportOur pricing is better than our competition's pricesWe don't have a lot of competition in our businessNot sure

Is your particular market place more generalized or specialized?

—Please choose an option—General marketSpecialized, Unique market placeNot sure

Do you have a slogan or tagline that clearly describes what you offer in terms of benefits or features?

YesNo

Do you know your customer demographic information (such as customer's income, interests, gender, age, type of computer they use, technically savvy, business-to-business, business-to-consumer, etc)?

YesNoNot Sure

What is your budget for this project?

—Please choose an option—$2,500-5,000$5,000-$10,000$10,000-$20,000$20,000-$50,000$50,000-$100,000Over $100,000

Are you the financial decision maker? What is your decision-making capacity?

I am the Owner / Sole Decision-Maker of my business;I am the Company President/CEO, have main decision making powerI am a Top Level Executive, have some purchasing powerI have the ability to make recommendations and suggestionsI do not have financial decision making power

Will someone at your company be our main point of contact for design/marketing/strategy decisions, or is there an internal team in place, which we will interact with?

—Please choose an option—One main person involvedMultiple people involved

Please list the names of five other sites that you like. Why are they attractive to you?

Have you researched what your competition is doing online, so that you have an idea of what you want, versus what you don’t want, on your site?
YesNo

Do you have website content ready for use on your website?

YesNo

Do you have a logo ready for use?

YesNo

How many products/services do you wish to sell online?

1-1010-2525-50Over 50

How many product/service lines do you have?

1-1010-2525-50Over 50

If you’re planning to sell online, are you set up to accept credit cards?
(Select all that apply)

Merchant AccountPayPalGoogle WalletNo, I don't have it in place.

Do you have someone available to handle online inquiries, requests or orders that come in via your website?

YesNo

Do you have a list of keywords and descriptions ready for website/project optimization?

YesNo

Do you have a traditional (off-line) marketing plan in place?
(Select all that apply)

Print Magazine PublicationsBillboards/SignageNewspaper AdvertisingPress/TV MediaOtherNo, I don't have an off-line plan in placeMy business does not require off-line promotion

Once your website/tech project is completed, how quickly are you expecting business to come in from it?

—Please choose an option—Instantly, I need the business to roll in right awayI expect business to roll in within one month from completion of website/projectI expect business to roll in within three months from completion of website/projectI expect business to roll in within six months from completion of website/projectNot sureNot in a hurry. Whenever it happens.

What else can you share with us about your business, which will help us to serve you better?

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