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E-SERVICES
* Name of the Business:
* Name of Owner/Manager:
* Business Address:
* City:
* Postal Code:
* Email:
* Phone Number:
Fax Number:
Do you have a website?
Yes   No
If Yes, what is the URL:
What primary Products and/or
Services do you Provide?
Best Describe your current Needs
(Mark what you need)

New Complete Web Site
New Complete eCommerce Web Site
New Complete Auction Web Site
Existing Site Needs Re-Design
Existing Site Needs new features
New Web Hosting Only

Other Needs: (Please Describe)


What is the Purpose of your Web Site?

Internet Presence
Attract Local Customers
Broader customer base
Convey and image
Provide information
Sell products on-line
Sell Information
Publish a newsletter
Collect user demographics
Set up Auction Site

Others (Please Specify)

What Services your Web Site need to provide? (Mark all what you need)

Company profile
Logo, Banner or other graphic design
Streaming Video and / or Audio
Contact / Information Request for Feedback Form
Service Page(s)
News / Announcements
Flash or other Animation
Map and Driving Directions
General Information /F.A.Q.
Downloadable / Printable Documents
Employment listings
Event Calendar
Product Pages
News Letter
Secure Online Credit card Processing
Advanced navigation (Fancy with roll over effect)
Protected User Areas
Shopping Cart
Photo Gallery Featuring photos

Do you have content written
for your Web Site ?
Yes   No
List 3 competitor websites and what you like/dislike about them





Other services desired:
Search Engine Submission:
Yes   No

CD ROM Presentation:
Yes   No
What are some short-term
goals for your site:
What are some long-term
goals for your site:
When would you like to have
this project completed :
2 Weeks
2-4 Weeks
1-2 Months
2-3 Months
3-6 months
What is the range of your budget?
(Please Mark )
$250-$500
$500-$750
$750-$1000
$1000-$1500
$1500-$2000
$2000-$2500
$2500-$5000
$5000-$7500
$7500-$10,000
$10,000-$15000
$15,000-$20,000
More than $25,000
When do you need this proposal by? (Please Mark )
Within 2 days
2-5 days
1–2 Weeks
2-4 Weeks
1-2 Months
Please contact me as soon as possible regarding this matter.

 

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