Thanks for considering Custom Web Solutions!

Please complete this form using as much detail as possible. The better we understand your needs, the more meaningful our quote will be.

Privacy Notice: CWS respects your privacy. The information that you provide is for CWS use only. Your information will not be sold or given away nor will you be placed on any mailing list.

* Required fields are in red

Contact Name *
  		E-Mail *
Company and/or Business Name
Address
City
,  		State
 Zip
Telephone Number



Preferred Method of Contact
Telephone     E-Mail     Either

What service are you interested in?*


If this is a redesign, what is the current URL?


Do you have a Domain Name (www.mycompany.com) registered?
Yes  No

Will you require hosting for your web site?
Yes  No

Type of Web Site Needed
Small Business
Non-Profit Organization
Personal or Family

What will be or what is the purpose of your web site?
Advertise my business.
Sell products and/or services.
To provide resource(s) or information.

List one or two web sites similar to your business that you like.



Estimated number of pages in your website:


How will you be providing the text for your web site?
I will provide all of the text with no editing required.
I will provide all of the text, but it will require editing.
I will provide most of the text, but it will require editing.
I will need you to develop and edit my text.

Do you have any graphics (photos, logo, artwork, etc) that may be used for your web site?
 Yes   No    How many graphics will you provide? 

Will any graphics (logo, artwork, etc) need to be created for your web site?
 Yes   No    How many graphics will need to be created? 

Do you have any animated graphics that may be used for your web site?
 Yes   No    How many animated graphics will you provide? 

Will any animated graphics need to be created for your web site?
 Yes   No    How many animated graphics will need to be created? 

Can you supply images in digital format?  Yes   No

Do you need any graphics or images scanned?
 Yes   No    If so, how many? 

Will you require regular maintenance?
Yes   No    If yes, which maintenance plan?

What is your anticipated budget for your web site?

What is the target date for completion?
   

What is your company's and/or organization's main product and/or service?
(Please be as detailed as possible)


Please give detail description of the general purpose and requirements of your site:
(Please be as detailed as possible)


What Applications, if any, would you like for your website?
(Check as many as you want)
Content Management     Customer Database    Photo Gallery     Slide Show     Calendar    Online Quiz   
Secure Customer Area    Sign-up forms

Are you interested in any of the following rich media?
Flash      Streaming Audio/video

If any, how many audio/video recordings will you need?

How did you hear about Custom Web Solutions?


 



Contact Info:
Phone:(573)893-4366
 
Postal:1521 Del Cerro Dr.
Jefferson City, MO 65101
 
email:custom.webs@gmail.com