| Bold
fields are mandatory |
| Name: |
|
| Email: |
|
| Phone
Number: |
|
| Service
needed: |
|
| Number
of pages: |
|
I'd
like the site completed by:
|
|
| I
will need ongoing maintenance: |
|
| If
yes, how often? |
|
My
budget is:
|
|
| Type
of site? |
|
The
look I'd like for my site is:
You may select more than one. |
|
My
color preferences are:
|
|
| I
have a company logo: |
Yes
No |
| Do
you need us to create a logo? |
|
| I
have my site content/text ready: |
|
| Do
you need a shopping cart? |
Yes
No
Maybe
Don't Know |
| I
have a domain name: |
Yes
No |
| Would
you like us to help you purchase one? |
Yes
No |
| I'm
interested in these domain names: |
|
| Would
you like us to host your site? |
Yes
No |
|
Please
list the Urls of at least three sites
that you like the layout or look of:
(They do not
need to be in your industry, we're just
trying to get an idea of your personal
taste)
|
|
|
Please
list your reasons for liking those web
sites here:
|
|
| List
any other details important to the
design of your site. |
|
|
|
Thanks
for your interest in Cypanet.
You will have a response within 1
business day.
|
Click 