name:
name of company:
street address:
city, state, and zip code:
email address:                                       telephone number (optional):
Which web page template did you choose for your site (if any)?
type of website: broshureware e-commerce
approx. number of pages needed:
web address preferences:
www.
1st Choice
Click on arrows and scroll down to prioritize your choices.
2nd Choice
3rd Choice
4th Choice
Which update plan best fits your needs?
Would you be interested in email marketing?
Will there be playable audio or video w/audio on your site?
yes no
Would you like for us to build a "flash" intro for your site?
Would you be interested in conducting a visitor campaign?
yes no
Do you have a logo, images, brochures, etc. that we could place on your site?
Additional Notes:
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