Name* :
Your Address* :
E-mail* :
Phone:
(Phone needed only if you are in Thailand)
Country* :
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegowina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and Mc Donald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea (North)
Korea (South)
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St. Helena
St. Pierre and Miquelon
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U S Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela
Viet Nam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis And Futuna Islands
Western Sahara
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
Other
Your website address:
Type of Business you want a website for:
GENERAL: What are your website design goals?
ECOMMERCE: Describe your e-commerce goals :
Sell online using credit card payment system?
Yes: | No:
Do you have a registered company?
Yes: | No:
GOALS: List some of your objectives/goals for your site
Example:
Should provide visitors everything they need to know about e-commerce (for a bank website)
When some one thinks of perfumes, they should think of our site (for a perfume website)
Describe briefly what you would like your website to do.
IMAGE: Describe the Image your website must communicate:
WEBSITE DESIGN ELEMENTS
Colors to use: Specify one or two model sites that show us the color combinations you want, or tell
us what colors you would like to use in your website.
Look and Feel, Structure and Layout: List any sites you like. Doing this will help guide us when we design your unique website.
Web page sections: List the major pages that you would like to have in your site. These pages will be controlled from the CMS.
Home
About us
Services
Products
Community
Contact us
Privacy statement
Other pages:
Features: Tick the features you would like to include in your website:
Inquiry Form
Flash banner
Flash introduction: Click to enter website, & Skip introduction link included
Shopping Cart
Discussion Forum
Chat room
Streaming video
Newsletter, registration dialog in website, and send PDF, HTML, or plain text
User registration
Advertising boxes controlled from CMS
User registration Describe what Registered Users can do on your website:
Advertising Where do you want to display the advertising in your web page?
Under header banner across page in 1 line
Left Column
Right Column
Banner above text
Banner below text
Will you supply a logo?
Yes: No:
Logo Design: Do you want us to design you a logo? Please describe what you would like in the logo
BUSINESS: Help us understand your business goals
How many years has your business or organization been in existence?
How many employees do you have in your company or organization?
Describe your involvement in this project:
Is this project part of your job responsibility?
Yes: | No:
How involved will you be in the process of developing your site?
Not much
I want to turn it over to you
Some interaction on design, text and features
I want to be involved every step of the way
Additional information about your project here:
Have you had any problems when you outsourced a website project before? Please tell us about them:
When would you like to launch your website?
January
February
March
April
May
June
July
August
September
October
November
December
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Technical Information
Do you already have a website hosting server?
Yes: | No:
If you have checked the above radio button, then what server technology does your hosting company use?
UNIX:
LINUX:
Win NT:
Solaris:
Don't Know:
What is your hosting company website address?
Search Engine Registration and Website Marketing (SEO):
SEO is a seperate contract you can sign if you wish after we have completed your website. Please review the SEO pages on our website for more information. If you want us to promote your site to search engines, please complete the following questions:
How important is it to you to get a high ranking on Yahoo, Alta Vista and other big search engines?
Not very important
It is good to
be listed
Extremely
important
How many visitors a day do you get to your website now?
Please list 5 key words that you think your potential visitors will use in a search engine like Google, Excite, or Yahoo while searching for a site like yours:
(Keywords are words that people use in a search engine to search for your site. For example, if you sell jewelry, they might use words like: jewelry, gems, precious stones, etc. More.... )
TELL us about yourself
Do you have a technical IT background?
Yes: No:
What is your level of understanding of the web?
Excellent |
Good |
Average |
Poor
BUDGET:
How much budget have you allocated for your website design project? *
(Numbers, commas, and decimal points ONLY!)