Contact Name:

Company Name:

Phone:

*E-Mail(REQUIRED):

Select Service Static web design or redesign Dynamic php/mysql solution Website maintenance Customization Corporate identity Flash or Multimedia Dynamic flex solution

Select Budget $300 - $500 $500 - $1,000 $1,000 - $3,000 $3,000 - $10,000 $10,000 - $30,000

Select Deadline 1 - 7 days 1 - 2 weeks 2 - 4 weeks 4 - 6 weeks 6 - 12 weeks 3 - 6 months 6 - 12 months

Select Type Small/Medium Business Personal Corporate Non-Profit Organization Portal

Current Website url(if any):

Addresses of the websites that suit your company's in style and reflection methods (a few websites that you like or that match your requirements):

Website language/s:

Approximate number of pages:

Please Select... 1 - 5 Pages 6 - 10 Pages 11 - 15 Pages 16 - 20 Pages 21 - 25 Pages 26 - 30 Pages 31 - 35 Pages 36 - 40 Pages 41 + Pages

What are the main sections of the website?

Do you need flash as header or menu?

Do you need a Full Flash web site?

Do you need flash intro?

Do we need to work with and customize any template?

What images to use? Where can we find them?

What texts to use? Where can we find them?

Preferred server-side scripting language/s(if any):

Do you need a CMS (content management system)?

Do you need a custom made CMS? (if open source, select CMS below)

Do you need a shopping cart?

If you need cart, will it be custom made (if open source, select below)?

Do we need to work with any existing database or script ?

If we need to work with an existing script, specify URL of demo:

Url to download the source code if existing script:

Provide details on your web site's dynamic requirements.

Logo:

Brochure:

Letterhead:

Business card:

Flash presentation:

Flash Intro:

Can you provide high quality pictures?

URL of the template your purchased(if any):

What script or CMS you want to customize?

Mambo Joomla Oscommerce Creloaded Phpbb IPB

Vbulletin Gallery Coppermine Other:

Do we need to provide unique design for cms?

(please also fill up the static or flash based web site section above as appropiate)

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