| Name |
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* required |
| Company |
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| Address |
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| City |
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| State / Postal Code |
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| Country |
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| Contact Phone |
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* required |
| E-Mail Address |
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* required |
| How Did You Find Us? |
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* required |
| Development |
New Site Redesign Existing Site |
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| Domain Name (URL) |
http:// |
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| Web Hosting |
Need Hosting Do Not Need Hosting |
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| Site Functions |
Info Resource - provide information
Marketing Tool - obtain new clients
Online Store - sell products/services
Other - provide details below |
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| Desired Features |
Database Integration
Internal Site Search
Multimedia Effects (i.e. Flash)
Online Form Submission
Opt-in E-Mail Newsletter
Shopping Cart w/ items |
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| Web Promotion |
Pay-Per-Click programs
Search Engine Optimization |
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| Project Budget |
(U.S. Dollars) |
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| Project Start |
(Estimated) |
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| Project Description (please be detailed) |
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| Additional Comments |
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contained within this
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