Fill Web Design Order Form
  1. The order below will help us with accurate contact and design information. All the information you provide will remain confidential and it will be used only for the purpose of drafting the Web design.
  2. CUSTOMER INFORMATION
  3. Contact Name*
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  4. Phone (include area code)*
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  5. E-mail Address*
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  6. Alternate E-mail Address
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  7. Web Site Address
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  8. How did you hear about us?*
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  9. DESIGN INFORMATION
  10. Your chosen package*
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    (you can still change the package at this stage if needed)
  11. Describe your business
    (i.e. what type of products or services your company supplies... etc.)*
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  12. Please describe the goals of your website
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  13. What type of overall mood would you like to project with your new web site?
    (Elegant, fun, trendy, techno, feminine/masculine, corporate... etc.)*
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  14. Please describe pages of your web site
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  15. Attach any relevant files
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  16. Do your competitors have websites? If so, please list some
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  17. Are there any websites that you like aesthetically, or are similar to what you are looking for?
    (Please include why you like them)
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  18. What custom programmed features are you interested in?
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  19. Total
    0.00 USD
  20. Select payment method
  21. Captcha*
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    Type in the textbox what you see in the image.
  22. By placing this order you submit that you have read and agree with our Terms and Conditions
  23.