• Please fill in the information fields below

  • Provide your e-mail address and phone number

  • We will contact you to ensure that we all have a clear view of your objectives.

  • Your quote will be based on your own individual needs.

  • THIS ESTIMATE IN NO WAY OBLIGATES YOU TO 
    PURCHASE A WEB SITE!!!
    (This simple form was created by V.M. using Perl and HTML)

CONTACT INFORMATION

NAME 


 COMPANY NAME 

     ADDRESS 

CITY 

STATE 

  ZIP 

        PHONE# 

     FAX# 

       PAGER# 

EMAIL(REQUIRED) 

  WHAT IS YOUR BUDGET 
 FOR THIS PROJECT 

ARE YOU FAMILIAR WITH
 THE SCIENCE OF WEB PUBLICIZING 

yes no

DO YOU HAVE AN ACCOUNT WITH
 A WEB HOSTING PROVIDER 

yes no

PROVIDER / SERVER NAME

DO YOU CURRENTLY 
HAVE A WEB PAGE? 

  yes no

IF YOU HAVE A WEB PAGE
WHAT IS YOU CURRENT URL ADDRESS?

                                                   

 

YOUR MULTIMEDIA AND WEB NEEDS

WHAT KIND OF MULTIMEDIA OR WEB SERVICE TO YOU REQUIRE?
CD ROM    DVD ROM
ENHANCED CD        

GRAPHIC DESIGN AND ANIMATION

NEW WEB SITE 

 INTERACTIVE WEB TRAINING 

REMODEL CURRENT SITE

 COMPUTER BASED TRAINING
WEB PUBLICIZING   FLASH AND DIRECTOR SHOCKWAVE

                                                                                     

  TYPE OF BUSINESS

WHAT ARE YOU GOALS AND OBJECTIVES OF YOU PROJECT?

WHAT MARKET WOULD YOU LIKE TO TARGET?
ELEMENTS OF YOUR SITE OR APPLICATION

                                                        

(CHECK THOSE WHICH MAY APPLY)

ORDER FORM PAGE    SHOCKWAVE MOVIES AND INTERACTIVITY
PASSWORD PROTECTED AREAS 3D GRAPHICS
DIGITAL VIDEO DIGITAL AUDIO   
STEAMING AUDIO/VIDEO   SHOPPING CART CAPABILITIES
CREDIT CARD PROCESSING    DATABASE CONNECTIVITY
WEB SITE STATISTICAL ANALYSIS  CUSTOM WEB GRAPHICS OR ANIMATION
CHAT ENVIRONMENT   MULTIUSER CAPABILITY

                                                                        

WILL YOU REQUIRE SITE PROMOTION OR PUBLICIZING?
In other words, would you like us to register your site with all important
search engines in such a way that your site is extremely
easy to find on the web?

YES I WILL NEED WEB PUBLICIZING!

 

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