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Name

Email Address

What is the main purpose of the website? What is the main purpose of the website? to sell products? to promote services? to collect email addresses? to build a brand / community? Informative

Do you want any of the following? Do you want any of the following? Blog / News Articles Social media integration Gallery Contact form Email signup form / ability to collect email addresses? Ability to sell digital products? Ability to sell physical products? Membership User account Multilingual Other (describe below)

What is your existing website's address? (If you do not have one, leave blank).

Do you want logo and branding? Do you want logo and branding? Yes No

Do you have any content at the moment? Do you have any content at the moment? Yes No

Do you want us to arrange hosting? Do you want us to arrange hosting? Yes No

Select from below to characterise your website’s brand: Select from below to characterise your website’s brand: Corporate Trendy / Adventurous Proud Rebellious Ambitious Accommodating

How many pages will the website have roughly? How many pages will the website have roughly? 1-10 ? 11-20 ? 21-100 ? 100+ ?

What is your estimated budget? What is your estimated budget? Under $1000 $1000-$3000 $3000-$5000 $5000-$10000 Above $10000

How did you hear about us? How did you hear about us? Search Engine Social Media Client Referral Friend Other

Who is the website’s target audience?

Ideally, How soon do you need the new website completed?

Two or three websites you admire or would like to emulate:

Anything else you want us to know?