Personal Information
First Name:
*
Last Name:
*
Business Name:
Address:
*
Address2:
City:
*
State:
select a state:
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
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Florida
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Michigen
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U.S. Virgin Islands
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Wyoming
OTHER: or NONE
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Zip Code:
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Country:
select a country:
United States
Afghanistan
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Andorra
Angola
Anguilla
Antartica
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Bouvet Island
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Isle of Man
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Jordan
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Korea, Republic of
Kuwait
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Mauritius
Mexico
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New Caledonia
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Panama Canal Zone
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Pitcairn
Poland
Portugal
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Singapore
Slovakia
Slovenia
Solomon Islands
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South Africa
Spain
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Sudan
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Swaziland
Sweden
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Taiwan
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Tonga
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U.A.E.
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Vatican City State
Venezuela
Viet Nam
Yemen, Republic of
Yugoslavia
Zaire
Zambia
Zimbabwe
*
Phone:
*
Fax:
Email Address:
*
Website Re-Design Information
Do you have a Domain Name:
Yes
No
*
If Yes, what is the name:
If No, what name do you want:
Is Monthly Maintenance Needed:
Yes
No
*
Select Web Site Re-Design Package You Desire: *
Package
Price
Select
1-10 Page Design
$300.00
11-25 Page Design
$550.00
26-50 Page Design
$700.00
51-100 Page Design
$950.00
101-150 Page Design
$1,200.00
151-200 Page Design
$1,500.00
201-250 Page Design
$1,800.00
251-300 Page Design
$2,000.00
300+ Page Design
$3,250.00
Will Products Be Sold:
Yes
No
*
If So How Many:
select #
1-10
11-25
26-50
51-100
101-150
151-200
201-250
251-300
300+
How Soon To Start:
select:
ASAP
1 Week
2 Weeks
3 Weeks
4 Weeks
1 Month +
*
Estimated Budget For Project:
select #
$500 - $1,500
$1,500 - $2,000
$2,000 - $3,000
$3,500 - $5,000
$5,000 - $10,000
$10,000 +
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Hosting Information
Do You Need Hosting:
Yes
No
*
if you answered no for the above question, please do not answer any of the following questions. if you answered yes for the above questions please answer the below questions.
Select a Hosting Package You Would Be Interested In!
?
Type
Price
Select
Starter
$5.95/Monthly
Premium
$12.95/Monthly
Ultimate
$24.95/Monthly
Website Addon's (all optional, Note: if you select these addon's with your flash web site design quote you will receive a discount for having them with your web site contract package)
Banner Rotator:
Yes
No
*
Web Calendar:
Yes
No
*
Live Help :
Yes
No
*
Recommend This Site Script:
Yes
No
*
Mailing List Manager:
Yes
No
*
Auction System :
Yes
No
*
Affiliate Program :
Yes
No
*
Link Tracking System:
Yes
No
*
Classified Ad System:
Yes
No
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Task Manager:
Yes
No
*
Web Site Content Manager:
Yes
No
*
Help Desk:
Yes
No
*
Shopping Cart:
Yes
No
*
Traffic Exchange:
Yes
No
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Banner Exchange System:
Yes
No
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Link Exchange System:
Yes
No
*
Forum (Custom Built):
Yes
No
*
Knowledge Base:
Yes
No
*
Guest Book:
Yes
No
*
Image Gallery:
Yes
No
*
News Manager:
Yes
No
*
Article Manager/Directory:
Yes
No
*
Rating System:
Yes
No
*
Search Engine:
Yes
No
*
Test or Quizzes:
Yes
No
*
Site Search:
Yes
No
*
Resume Builder:
Yes
No
*
Membership System:
Yes
No
*
Web Ring:
Yes
No
*
Top Site System:
Yes
No
*
Custom Built Blog:
Yes
No
*
Poll System:
Yes
No
*
Survey System
Yes
No
*
Chat Room (Built in Flash):
Yes
No
*
Online Catalog:
Yes
No
*
Ad Manager:
Yes
No
*
Store Locater System:
Yes
No
*
Graphs & Charts:
Yes
No
*
Portal System:
Yes
No
*
Real Estate System:
Yes
No
*
Contests & Awards:
Yes
No
*
Billing System:
Yes
No
*
Services Quote System:
Yes
No
*
Redirect System:
Yes
No
*
Other:
Additional Information
Send Quote By:
Email
Phone
Fax *
Best Time To Call:
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Morning
Afternoon
Evening
Anytime
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Where did You Hear About Us:
select method:
Email
Message Board
Another Site
Search Engine
Ezine
Advertisement
Banner
TV
Affiliate
Reseller
Word of Mouth
Office
Other:
*
Other if Chosen: