Web Design Form


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Please answer the following questions to help us create your web site. More information is always better so please elaborate so we can start designing right away to provide you with samples to choose from. This list of questions was created to help us learn as much information as possible quickly. We may have more questions more specific to your project.


Please enter the name of the person who referred you to our services. Our referrals are very important to us.
Referred By
Contact Information
Company Name*
Email Address*
Email Address Confirm*
Postal Code/Zip Code*
If yes, do you have the file in jpg, ai, eps, pdf digital format?
If no, will you require a logo to be deisgned? (Additional Cost)
Do you have any color preferences, or existing brand colors?
Do you have any colors that you do not wish to use?
Do you have a current business card?
If no, will you require a business card to be designed with your branding? (Additional Cost)
What information would you like to have on your business cards?
Domain Name Information
Do you have a domain name?
If yes, what is the domain name?
Domain Registration Company:
Is your domain currently hosted with anyone?
If yes, Hosting Company Name:
Hosting Log-In web site:
User Name & Password to be provided
Email Account Information
Do you have an email account set up with this domain name?
If yes, which email accounts are currently set up?
If no, what email accounts do you require to be set up?
Do any email accounts need to be forwarded?
If yes, which account to which account:
Web Site Functionality:
Other Goals for your site:
Other features you may like on your site?
Social Media
How many times could you TWEET per week?
Would you like a custom Twitter Background? additional charge
Does you product/service change regularly?
What product/service would your customer be interested in hearing about?
Email Marketing
How many email campaigns would you like to send per year?
Do you have an existing database of clients/customers?
Do you have a means of adding to your database?
Will you want to create a branded email campaign?
What type of opt-in mail list gathering will you use? Do you have a program in place to manage in-house newsletters, bulk personalized e-mails and removal requests? Consider custom forms for gathering information on your site.
Web Site
Who is your target audience or demographic?
Who will create the content for the site?
What content will need to be updated and how often? You will be able to update content as you see fit, we need to ensure we make this as easy as possible for you. Please list the content you will need changed regularly.
Will content be new, rewritten, or both?
How many MAIN pages will you require?
How many SUB pages will you require?
What is the purpose of your site?
Desired Layout
Website Style:
Do you have a Business Slogan? If yes, what is it?
Contact Information: What are all the different ways visitors can contact you? For example, name, address, phone, fax, 1-800, e-mail addresses, international offices.
Will you require any videos on your site?
Will you be posting new articles, products, or services regulary that you will want to show case?
Will you require space for advertising: internal or external ads?
Will you require a custom banner to be designed?
Will you require a custom favicon to be designed? This is the symbol that appears in the address line beside your url.
Will you require a 'Contact Us' form to receive emails?
Do you have a custom image you would like to have as the background of your site?
How do you plan to promote your product and website?
Write a 25 word description of your business to be displayed and used in search engine submissions. Describe what your business offers, to whom it is offered and a succinct reason your business should be considered.
What are the 30 key words people would use to search for your service or product in google?
Sizing up your competition: list 5 competitors web sites
List your favorite 5 websites:
Problems: List any current problems experienced with your existing website (poor performance, graphics, load time, design, etc.).
Web Site Security, Will there be password protected areas for dealers, members or downloads?
What’s your preferred deadline?
*NOTE: In the event your custom design requires the purchase of any graphics, clipart, fonts, vector art, etc., that I do not have, the additional costs will be added to the base price.
Once you have completed the online submission form please press the submit button to the right. IF you have not completed a required section, a notice will appear at the top of the page asking you to enter the information.

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