1.
Name
2.
E-mail
3.
Telephone
4.
Title
5.
Company
6.
Address line 1
7.
Address line 2
8.
City
9.
State
VIC
NSW
ACT
QLD
NT
TAS
WA
SA
10.
Post Code
11.
What products and services do you offer, sell or supply?
12.
Do you already have a website?
Yes
No
13.
Enter Your Domain Name, If you have one
14.
What pages would you like to include on this website?
15.
What other additional features and functionalities would you like to include?
Flash Animation
Custom Driving Map
Content Management
Audio Streaming
Video Stream
Site Map
Inform-a-Friend
Password Protected
Flash Intro
16.
Do you need an online store (shopping cart) to sell products / services on-line?
Yes
No
a.
About how many different products will you sell on-line?
b.
How do you want to process credit card transactions?
Manual
Automatic
17.
Will your site require an online database?
Yes
No
If yes, explain the function of this database.
20.
List 3 sites that you really like the look and feel, so we can have a better understanding of what you are looking for:
21.
List 3 of the top competitor sites:
22.
How soon do you need this project completed?
14 Days
21 Days
28 Days or more
23.
Will you provide us with all the text for the website?
Yes
No
24.
Will you provide any imagery for your web site?
Yes
No
25.
Will you need a logo developed?
Yes
No
26.
Will you need professional photography services?
Yes
No
27.
Budgetary constraints ($):
29.
Please enter any additional information you would like considered in the preparation of your price quote.
30.
How did you hear about DBurns Design?
Google
Yahoo
Newspaper
Other Search Engine
Flyer
Referred by Friend