Basic info

Your name^* 

Your address^*

Your email address^*

Phone (with area code)^*

Fax (with area code)

Select a type of web site Home site Business site ^*

Web scheme
Favorite colors:   select up to three  -  or specify Other
Red   Blue   Navy  Green  Yellow   Black   Grey   Orange 
Purple   Pink   Teal   Lime   Peach   Cream   Brown

Hue preference:  Pastel   Dark    No definite preference

Theme (like computers, sports, music, gardening, travel):

Mood:   Action oriented   Thoughtful   A little of both

Impact:  Simple   Flashy   Undecided

Background and images: Custom   Stock

Web details

Domain name (if you have one already)   Check for domain

Web host company name (if you have a host already)

Web host phone - with area code

Pages you'll need - check all that apply^*
Home   Sign in   Guestbook   Order form   Samples   Links
Catalogue  Feedback
Other/additional pages      Estimated total:   1 to 5 6 to 10 11 to 20 21 to 30 31 to 50 51 to 100 More than 100

Features you want - check all that apply
Visitor counter   Shopping cart   Background music   Voice audio
Special java applets   Data base handling   Site "search" capability
Other or additional features

Animation:    None   Some   Lots         Type(s):   Clipart    Custom

Photos:    Yes   No

Special considerations

Importance: Cost   Uniqueness   Undecided

Frames:  No   Yes   Need advice   Undecided

Browser compatibility:  Aim low   Aim high   Need advice    Undecided

Questions and comments

Use this box to address any additional needs, questions, or comments you may have: