This form will take 15 to 20 minutes to complete. Please be as detailed as possible about your answers, as they are what will guide us in envisioning a Website design that will best represent you, your company, interests, or organization.

Your Name (required)

Name Of Organization (required)

Primary Contact's Email (required)

Person Responsible (if different than primary contact)


Telephone Number (Landline)

Telephone Number (Mobile/Text)

Website (required)

Facebook Page

Twitter Page

Linkedin Page

YouTube Page

Other Social Media Platforms

Defining Your Desired Website Style.

Who is your direct competition?

What do you like or dislike about their Websites?

What products and/or services, distinguish you from your competition?

Identify (up to) 4 Websites (URLs) that reflect the style, color, and feel you would like for your Website:


Likes or Dislikes about their site


Likes or Dislikes about their site


Likes or Dislikes about their site


Likes or Dislikes about their site

Describe the colors and style/feel you would like to have in your Website

Defining Your Audience

Describe your target market (ex: professional women ages 18-24, etc…)

Defining Your Website Priorities

Feature Info About ServicesAdvertise ProductsSell Products or ServicesBrand DevelopmentAll Of The Above

Additional Information

Style (Select the most appropriate statements)

Easy To MaintainProfessional Style and Feel WarmWelcoming – casualFlash, Graphics, AnimationLoad quickly: less graphicsProfessional Style and Feel

Additional Information

Expected Number of Pages (Approximate) 1-55-1010-20MORE

Will your site have forms or newsletter subscription form? YesNo

Describe the forms needed

Do you currenly have an email marketing account

Other Service (if applicable)

Describe the graphics you can/will provide (Logos and formats)

Describe the graphics to be developed by the Web design team

Stock photography requirements/budget, if any.

Will your site feature files/graphics to be downloaded for free? YesNo


Technical and Security Considerations

Will your site use a shopping cart (If so, you will require shopping cart technology, merchant accounts, and the ability to accept credit card payments. A secure area for your site may also be required.)

Would you like customers to have the ability to book appointments online?

Will your site feature a ‘members only’ area? (This will also require a password-protected area which may or may not require a secure area.)

Will your site require the use of a database to update and store product info?

Will your site contain Flash, video, audio, or animations?

Additional Information