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  sampled (dotorg) Client Consultation Form

This preliminary quote will help to define your goals and requirements for your site, while giving us some basic information on your business and your project objectives.

By completing as much information as possible carefully and thoughtfully will enable us to provide you with an accurate quote on time and price for your site.

If you have any questions or concerns along the way please don't hesitate to contact us.

Completion of this form is NOT a contract and is NOT binding in any way.
All fields marked with a * are required
First Name *
Last Name
Title / Position
Business Name
Business Address
Day Phone #
Evening Phone #
Other Phone #
Fax #
Email Address *
Method of Contact Phone
Email
Do you currently have a web site? Yes
No
Which of the following might you require for your site? New Web Site
Site Redesign
Web Hosting
Site Enhancement
Domain Name Registration
Photos
Graphics
Logo Creation
Database
E-Commerce
Web Site Maintainance
Site Promotion / Marketing
Security
Forms
Site Search
Business Card Design
Community Development (message board, chat etc.)
Other

Briefly describe your project. Include things such as the purpose of the site, target market, and features it may contain.

Briefly describe your business and the products / services you provide.

Requested Completion Date    
Do you have a specific budget in mind? $

If you require Domain Name Registration please list you top 4 choices, incase your first choice is already taken.

* Try to choose a Domain Name (example: sampled.org) that is easy to remember and that is related to your business name, products or services

1.
2.
3.
4.


Do you have a specific layout or design in mind for your site?

List 4 web sites that you admire.

1
2.
3.
4.

Is there a specific font(s) you would like to use on your site?

Yes
No

Does your business currently have a colour scheme that will be used on your site?

Yes
No

Sections / Pages Home
Contact
About
News
Services
Products
Site Map
Other
Other
Other
Other

Who will be responsible for maintaining and updating your completed site?

Your company / In House
sampled.org
Other

Who or what is your direct competition?

Are you affiliated with any other businesses or organizations?

Yes
No
Notes, Special Instructions, Thoughts, or Comments   Please list any additional information here.