|
Contact Name
|
* |
|
|
|
|
Company Name |
|
|
|
|
|
State |
|
|
|
|
|
City |
|
|
|
|
|
Phone |
*
|
|
|
|
|
Fax No. |
|
|
Email Address |
* |
|
|
|
|
How would you prefer to be contact |
|
|
|
|
|
|
|
|
Interested in:- |
|
|
|
|
If you currently have a Website please supply the website Address here
|
|
|
|
|
|
Will you need domain name requested for your website |
|
|
|
|
|
Will you need hosting to your Website |
(Please supply Web Address of a host )
|
|
|
|
|
Approximately how many pages you will need for your website ?(Common pages include :Home,About Us, OurServices,Contact Us ,etc..) |
|
|
|
|
Project Description
(Please, Describe what you envision for your website, also if you have any specific requirements, please list here) |
|
|
|
|
|
What is your projected budgut for this project?(please be relistic here so that we may be better serve you.) |
|
|
|
|
|
Are there any existing wesite that closely match the functionality or Design style you wish to have for your new website? |
|
|
|
|
|
How did you hear about indusmind.com? |
|
|
|
|
|
Do you have any additional comments and or Requirement that you feel may be important?
|
|
|
|
|