Services - Questionnaire

Preferred Title

Mr Mrs Miss Ms Dr

First Name: *

Last Name *

Business Name:

Address1:

Address2:

Suburb:

  State:  Postcode:

Country:

Best Contact No: *

   Work Ph No:   

Fax No:

   Mobile:

e-mail: *

Have you registered a domain name?

Y N

Name: 

Do you have a current web site?

Y N

URL:   

Have you registered a business name?

Y N

Name:  

Do you have a company logo?

Y N

Are you selling Services, Products, Both
or are you a non-profit organisation

S P

  Both     N/Profit

Do you require a secure on-line
payment service?

Y N

Please give a brief description of
your business

Do you require photographs for your
site?

Y N

or, supply your own   Y N

What are your expectations from
a web site?

Please give a brief description
of your customers and their needs

Do you have a preference for colours?

Y N

 Which colours?
 

Is it better to contact you -            

am

pm

THANK YOU
for taking the time to fill out and submit this form. We would be pleased
to help you attain excellence in your web presence