* What is the name of your company/brand?

* Add what your company does

First and last name, email and phone details of contact person

* Do you want to improve an existing website, or create a website from scratch?

What is the URL of your existing website (if any)?

What do you like and dislike about your existing website?

* Do you need us to buy the domain for your site? * Do you need us to buy the domain for your site? Yes No

* Do you need us to handle hosting? * Do you need us to handle hosting? Yes No

* What’s your deadline for this project?

* Could you give us a rough estimate of your budget for the website project?

I want this website because I want this website because I need to build awareness for my brand I need to offer a contact point to my clients I need my company to have a better image online I need to sell my product/service through my site I need to use it to build customer loyalty I need to reach people in many languages I need somewhere to promote my latest product/service Other

If other please provide details

My site will be built to target: My site will be built to target: Business Customers Consumers Awareness Other

If others please provide details

I’d like to target clients who are I’d like to target clients who are Kids & teens In their 20s In their 30s In their 40s In their 50s Senior citizens

Someone’s searching the web for your business / organization. What words or phrases will they search for in Google? Separate words using commas.

Our new website would need to include: Our new website would need to include: A basic HTML site An HTML5/ CSS3 website Responsive design for use on tablets & mobiles WordPress-based CMS Online Magazine Online forum Blog Newsletter system Social network integration Separate, dedicated landing pages A redesign of a current website Additional request

Additional request

We want the following special features to be included in our new website: We want the following special features to be included in our new website: Registration form Video streaming MySQL Database Search panel Multicolumn layout Newsletter/ Email sign up forms Information/ request forms Uploads/ downloads Customer login Registration An online store/shopping cart Online payment gateway Blog module Image gallery Image slider

* Do you have the content ready for your site? * Do you have the content ready for your site? Yes No

* Help us out here - Who will provide Stock Photography? * Help us out here - Who will provide Stock Photography? You (client) Us (web designer)

* Who will provide Company Photography? * Who will provide Company Photography? You (client) Us (web designer)

* Who will provide Other Artwork/ Illustrations? * Who will provide Other Artwork/ Illustrations? You (client) Us (web designer)

* Who will provideTranslation Costs? * Who will provideTranslation Costs? You (client) Us (web designer)

* Who will provide Text Copywriting ? * Who will provide Text Copywriting ? You (client) Us (web designer)

* Who will provide Professional Logo? * Who will provide Professional Logo? You (client) Us (web designer)

* Who will provide Graphic Design? * Who will provide Graphic Design? You (client) Us (web designer)

* Who will provide Other Print Collateral? * Who will provide Other Print Collateral? You (client) Us (web designer)

* Who will provide Metatags / description? * Who will provide Metatags / description? You (client) Us (web designer)

* Help us out here - Who will provide Font Licenses? * Help us out here - Who will provide Font Licenses? You (client) Us (web designer)

* Does your company have a logo / established image and or branding guidelines (e.g. fonts, colour schemes etc)? * Does your company have a logo / established image and or branding guidelines (e.g. fonts, colour schemes etc)? Yes No

* Do you have print materials (such as business cards or brochures) that we need to match? * Do you have print materials (such as business cards or brochures) that we need to match? Yes No

If you had to pick 3 websites you would love to have, which would they be?

Would you like us to update your site or would you like to be responsible for updates? Would you like us to update your site or would you like to be responsible for updates? Yes No

Would you like to book a dedicated training session for your employees to learn to update the site? Would you like to book a dedicated training session for your employees to learn to update the site? Yes No

Is there anything else you’d like to tell us?

Any other service required apart from web development Any other service required apart from web development Email Social media account creation Search Engine Optimization Email Newsletter (Promotional Emails) Other

Please provide any other service(s) you may require apart from web development.