Client Intake Business/personal informationName* First Last Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Name* Mission Statement / Slogan Do you have a logo? If so, please upload.Accepted file types: jpg, jpeg, png, gif.How many employees do you have? Years in business? If you already own a domain name or have an existing website, please enter it here. Project informationEstimated timeline for completion? Which services are you interested in?* Domain name registration Website design and development E-commerce / shopping cart Brochure design Business card / letterhead design Google Ads support Social media marketing (Facebook, Instagram, Twitter, etc) Website maintenance Photography Video production 360-degree photos and/or video If you currently have a website, why are you redesigning/changing?What is the purpose of your website? Provide information on products / services E-commerce / online sales Improve customer service Broaden your customer base Keep in contact with current customers Membership portal Other Are there any business affiliations, certifications, or memberships you'd like to promote? If you have color preferences, please tell us about them.Do you have any competitor or other websites that you like? Please give the URL's and what you like or hate about each.General layout. Please provide a site structure, listing how many pages you think the site will require.Do you have your own text for the website? Yes, we have our own text No, we will need you to write it Comments. Please tell us anything else that we may need to know about your project.CommentsThis field is for validation purposes and should be left unchanged. 652
