New Customer Form

New Customer Form

I require certain new customer information prior to starting a project. This information helps me see what your tastes and expectations are which helps me create your quality Web site. Please take a moment to fill out this form. Thanks!

Web Page Information 

Are there any sites on the internet that you are particularly fond of? If so, please list in the space provided below:

Do you have a specific color in mind for your web site?

Yes No

If yes, what? 

Approximate size of web site?


Do you have a Web Host?

Yes No

If yes, who? 

Do you have a Domain Name?

Yes No

If yes, what? 

Budget for this project?

Is there a deadline?

Please describe your sites objectives:

Brief description of company / organization:

Personal Information 

Who will be in charge of making decisions regarding this project?

First Name:

Last Name:

Company Name:

Street address:



Zip/Postal Code:




Company URL: