Web Design Intake

Full Name*:

Business Name*:

Contact Email*:

Contact Phone*:

Project Completion Date*:

Type of Website Project*: Please please select your question type. New Design/Development Re-Design/Development

Budget*:

Any additional comments*:

Do you require a logo design/redesign?*: Please please select your question type. Yes No

Target Domain*:

Number of pages you want?*:

Do you want drop-down menus?*: Please please select your answer. Yes No

Does the site require a blog installation?*: Please please select your answer. Yes No

Does the site require an email auto responder system?*: Please please select your answer. Yes No

Does the site require a newsletter system?*: Please please select your answer. Yes No

Does the site require any type of lead capturing systems?*: Please please select your answer. Yes No

Do you want to receive Payment on your website?*: Please please select your answer. Yes No

If you want to receive payment on your website, who is/will be the payment processor:

Does the site require membership access?*: Please please select your answer. Yes No

Does the site require a mobile version (Not a mobile app)?*: Please please select your answer. Yes No

Do you require a shopping cart (Ecommerce)*? Please please select your answer. Yes No

Please list all of the functionality requirements for your website outside of the questions asked above:

~Please remember to be as detailed as possible and feel free to provide reference sites

Do you wish to sell physical product or virtual product?*: Please please select your answer. Physical Products Virtual Products Both Physical and Virtual Products

Are you going to provide downloads?*: Please please select your answer. Yes No

Please list all of the functionality requirements for your website outside of the questions asked above*:

~Please remember to be as detailed as possible and feel free to provide reference sites

Additional Comments About the Target Website and Design that would assist Us*:

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