Company Name:*
Your Name:*
Address:*
City:*
State:*
Zip Code:*
Office Phone:*
Cell Phone:
Email:*
Website Address:
If you have spoken with someone at our company, please select their name:
click and choose from list
Justin Oswald
Greg Beutel
Joe Brennan
Ryan Parshall
1. Company Services
2. Business Mix %
Residential
%
Commercial
%
Industrial
%
3. Your Target Audience
Consumers:
Age Range
18-24 25-34 35-44 45-54 55-64 65+
Gender
Male Female Both
Annual Income
under 40K 40K-59K 60K-79K 80K-99K 100K-149K 150K-199K 200K-299K 300K-449K 500+
Home Value
under 100K 100K-159K 160K-199K 200K-249K 250-299K
300K-399K 400K-499K 500K-999K million+
Other Target Descriptions
Businesses:
Industries /Types:
Employee Size:
1-10
11-25
26-50
51-100
250-500
500+
Revenue Size:
under 100K
100K-499K
500-999K
1M-3M
4M-10M
10M+
4. Service Area
(Specific Cities/Towns, Counties, States, Countries)
5. Visual Branding
What information, look, feel and emotions do you want to convey to the user immediately upon viewing your site?
6. Company Logo
Use Existing Logo Update Existing Logo Need New Logo
7. Marketing Materials: Do you have any marketing materials - postcards, brochures, flyers that we can reference for visuals or copy?
Yes No
8. Search Keywords or Phrases
9. What do you like best about your existing website? (If Applicable)
10. What do you like least about your existing website? (If Applicable)
11. Who are your main competitors? Website addresses?
Company Name
Web Address
12. List some websites that you like and indicate what specifically you like about them, i.e. colors, design, layout, navigation, pictures, etc.
Web Address
What you like?
13. What pages would you like to include in your website?
Home Page
Contact Form
About Us
Testimonials
Services
Photo Gallery
Blog
Other: (Please List)
14. Would you like a CMS (Content Management System) to make changes yourself?
Yes No
15. Website Photography/Illustrations:
Providing Images Use Stock Images (FREE) Both
16. Website Copy:
Providing Copy Providing Copy - Need Editing & Proofing Need Copy Help
17. Do you want your website to have flash (video motion) special effects? Please describe (type, where on the website, duration, etc.)
18. Will you require customers or prospects to make any payments on-line? Please describe.
Yes No
19. Would you like Social Media integrated into your website/blog?
Yes No
20. Are you interested in our monthly Social Media Managment Services?
Yes No
21. Are you interested in monthly SEO (Search Engine Optimization) to maximize your website exposure?
Yes No
22. Are you interested in monthly SEM (Search Engine Marketing) to to increase traffic & leads through Google, Bing and Yahoo?
Yes No
23. Check the box that best fits your expectations and budget range for this project?
Below $1000
$1,000 to $3,000
$3,000 to $5,000
$5,000 to $7,000
$7,000 to $10,000
$10,000 to $20,000
$20,000 to $50,000
$50,000 to $100,000
24. When would you like your website completed?