Free Quote Work Sheet

My name is:
Company or organization:
My e-mail address is:
My phone number is: (optional)
My street address is: (optional)
City, State, Country: (optional)

 

I my own domain name address such as WWW.MYNAME.COM
Domain Name I would like to obtain: 1st Choice: 
Domain Name I would like to obtain: 2nd Choice:
My Domain Name is:
Please quote my website based on
The theme of my website will be:
The basic design of my website should be
I would like the website to consist of a Home Page PLUS (how many?) additional pages.
The additional pages I need are: Guest Book  Internal Search Engine  Order Form  Links Page
Accept Credit Cards  Video Files  Audio Files  Live Streaming Video & Audio
Feedback Page  Contact Page  Information Page  Other:
Other:  Other:
Artwork will be as follows:  
I will supply the text in this format:
I will supply (how many?)
I will also supply (how many?)
I will also supply (how many?)

I would like Executive Web Design to design a logo for me.
These special features are REQUIRED on my website:  
Shopping Cart - description (optional):
My web store will offer approximately (how many?) items for sale.
Each item for sale has

Type of product display required (standard or custom pages):

I would like a website on: DynamicLinks.net  OR Brockton.net OR  BOTH instead of my own Domain.
EXAMPLE:  www.DynamicLinks.net/yourname
I have no idea what I want for a website.  Just design one for me.
I have   do not have  INTERNET ACCESS.
I want all e-mail forwarded to the following e-mail address:
I want Executive Web Design to submit my site to the following search engines:
Yahoo  Excite  HotBot  Altavista  Lycos  Info-Seek  DynamicLinks  Snap  Other
 My site will need updating:  every day  once a week  once a month  only on request  Other


Additional information: