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First Name
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Email Address
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Business Name
Type of web design do you need?
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Build new website
Rebuild a current website
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Website or Domain
Do you have a web hosting account for this site?
Yes
No
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Tell a little about your business:
Describe your target audience:
Special features your site should have:
Do you want a content mgmt system like Wordpress?
Yes
No
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Will you sell products on your site?
Yes
No
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Number of pages you desire for your site:
Do you have a logo or images you want to use?
Yes
No
Not sure
URL(s) of 1-2 sites that you like:
Approximate Launch Date:
MM
/
DD
/
YYYY
( mm / dd / yyyy )
Additional Information:
Preferred format
HTML
Text
Mobile
