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Please complete all relevant information
Contact details
Your name:
Organisation:
Street address:
City, Post Code:
Country:
Phone:
Fax:
Email:
Site requirements
Do you have a web site?:
Yes
No
If yes, URL (address):
Do you have a hosting agreement?
Yes
No
Do You Have A Logo?:
Yes
No
Logo in electronic format?:
Yes
No
Do you intend to keep the site updated? If so, how often?
Types of Pages Needed for Site
What types of pages do you need for your site?
Flash intro page
Home page
About us
Product / Organisation Info
Guestbook
Forum
Links
Contact us
Other Pages (please list):
Total # of Pages Needed:
Shopping Cart
Yes
No
Donation and payments collections online
Yes
No
Do you already offer transactions online?
Yes
No
Will you have database functionality?
Yes
No
Do you already have a database in place?
Yes
No
Video
Yes
No
Audio
Yes
No
Mailing list
Yes
No
“Search this site” feature
Yes
No
“Print the page” feature
Yes
No
Other Scripts
Yes
No
Do you have content for site & images:
Yes
No
Colour Preferences:
Please list 3 similar sites that you like & why:
Time Frame Requirements:
Budget Requirements:
** Special scripts, databases, flash, programming, e-commerce do not fall under the regular price per page - additional charges apply and will be included in your quote.
Copyright 2005 Basilica Design
