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INTAKE FORM
Give us information about your current business/website and needs!
Your Name:
*
First
Last
Email Address:
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Enter Email
Confirm Email
Priority:
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1 (Very Low)
2
3
4
5 (Very High)
Needed By:
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MM slash DD slash YYYY
Type of Request
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Choose as many as are relevant.
Website Design / Development
Website Hosting
Website Repair / Support
Videography
Graphic Design
Writing Services
Strategic Consulting
Project Management / Operational Support
Mentoring / Training
Do you currently have a website?
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Select One
Yes
No
What is your website URL?
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Tell us more about your company, organization, or yourself.
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What kind of story do you want your website to tell? Who are you?
What sort of website do you need?
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Academic: Journals, education-related, cv's, etc
E-Commerce: sell services or products
Membership: Organization or club
Personal: Blogs, photos, or vlogs
Do you have graphics for the site?
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Yes
No
Not Sure
What would you like your website to do?
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Choose as many as are relevant.
We're here: create an Internet presence
This is who we are: reflect vision/purpose
We're the best: be better than competitors
Provide knowledge: feature information about products and services
Sell lots of stuff: a large online storefront, advertise and/or sell many products and services
Sell a little stuff: an online storefront with just a few products
Join us: Allow people to join our organization or club / learn about our organization or club
Learn about me: personal website with information about myself, my resume, etc.
Create a resource: e-journal, wiki, directory, etc
Privacy please: Private members-only section - password protected
Gather information: have forms and question sets
Disseminate information: provide subscriptions to newsletters/blogs
Other
Other:
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Please Specify
Define your website style for us, please.
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Find a few websites ( preferably in the same genre as your site ) & tell us what you like and don't like.
Describe the colors and feel that you'd like to see in your site.
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What is your target audience?
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What are your budget requirements or restrictions?
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Check any of the following that apply:
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Our site should have a very professional style and feel.
Our site should be warm, welcoming – casual.
Our site should load quickly – less graphic intensive.
Our site should feature lots of cool graphics, animation.
Our site should be easy for us to maintain ourselves.
Our site should be accessible to everyone ( the blind, deaf, & so forth, following guidelines).
Other
Other:
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Please Specify
How many pages will you need for the site?
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Who referred you to us?
Additional Information (if needed)
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About
Our Story
Services
Mission & Vision
Team
Portfolio
Contact
Client Portal