Your
Name (required) :
Company
Name:
Phone
Number (required) :
E-mail
Address (required):
Estimated Project Start Date:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2010
2011
2012
2013
Company
Industry:
Select
Other/Not Listed
Automotive
Construction
Church
Electronics
Financial Services/Accounting
Food/Beverage
High-Tech/IT
Manufacturing
Ministry
Medical/Healthcare
Pharmaceuticals
Real Estate
Retail
Service
Needed:
New Website
Development Website Upgrade/Redesign/Maintenance
Current
URL:
Size
of Company/Organization:
Select
Small
Medium
Large
Other
Number
of Pages Needed:
Select
5
10
11-15
16-20
21-25
26-30
31-35
36-40
41-45
46-50
More Than 50
Additional
Services Needed:
Ongoing Website Maintenance
Managed Web Hosting
Domain Registration
Database Design
Search Engine Marketing
Real-time Credit Card Processing
Logo Development/Design
Site Statistics
Administrative Interface
E-Commerce/Shopping Solution
Security Features
Search Features
Additional
Project Info:
What
is the purpose of your website?
Select
Information Resource
Sell Products/Services Online
Marketing Tool/Lead Generator
Personal
Please
list a couple examples of websites that
you like (optional) :
What
kind of website are you interested in?
Select
Simple,
Streamlined Site
Serious
Stable Site
Exciting
Dynamic Site
Highly
Graphical
Flash
Site and/or Intro
What
is your budget range?
Select
$500 - $1000
$1,000 - $1500
$1,500 - $2,000
$2,000 - $3,000
$3,000 - $5,000
$5,000+
How
did you hear about us?
Please use this space and
tell us all about what you
are looking to do. Since everything
we do is completely custom,
your needs and desires are
very important and will help
our creative development team
deliver exactly what you are
looking for. Here are some items that we're looking for:
A brief overview
of what the site will entail.
What are your goals for your new design? (Examples ideas: to minister to or educate people, sell products, inform people about our business/ministry, gather information for things like mortgage loans, take donations)
How will you measure the success of the new design?
IMPORTANT NOTICE! TLCWebHosting.com respects your privacy and
will NEVER sell or distribute your personal information to unless you are informed first.
You can rest assured that your personal/business information, including your email address, will be kept in strict confidence.
We may use a seperate company from TLCWebHosting.com for design work and so we may share some of your information with them.
