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Fill out the following form, submit it, and we will start working on your project.  We will process your request as soon as possible.  This is NOT your final order.

 

You are only required to complete certain fields and we've marked those with "(required)."

 

For your convenience, we are trying to keep this form as simple as possible, so if you have any ideas on how to improve it, type them in the "Additional Comments" close to the bottom of the form.

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Estimate Request Form

 

CONTACT INFORMATION

 

Full Name (required):

Company (if personal, type in "myself"):

Phone Number (required):

E-mail Address (required):

Address:

Address 2:

City/ State/ Zip

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BUSINESS INFORMATION

 

Company Type:

Education Individual Manufacturing Retail Technology Other If Other,

Number of Employees:

1-5 6-10 11-25 26-50 51-100 101-200 201-500 501 and up

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WEB DESIGN INFORMATION

 

Size of your Web site (in pages):

1-7 8-10 11-15 16-20 21-30 31+ Don't know

Will you need custom graphics?

Yes No Don't know

Do you have a logo?

Yes No

Do you own a Domain Name?

Yes No Don't know

Will you require Web Hosting assistance?

Yes No Don't know

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Additional Comments:

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