Name
:
Company
:
Phone
:
Fax
:
Email
:
Existing website
address (if any)
:
What
type of service(s) Do you
require? (tick all that apply)
:
Web design Flash
Introduction Online
forms Graphic
or logo design Flash
navigation Database
Solutions E-commerce
solutions (shopping carts) Audio
streaming Video
streaming Site
maintenance Self
content management system Search
engine optimization Marketing Consultancy
What
is your budget in Indian Rupees?
:
Rs
5,000 - Rs 12,000
Rs
12,000 - Rs 20,000
Rs
20,000 - Rs 40,000
Rs
40,000 - Rs 80,000
Rs
80,000 - Rs 1,00,000
Rs
1,00,000 - Rs 5,00,000
Rs
5,00,000 - Rs 15,00,000
Rs
15,00,000 - more
What
materials will you be
:
Copy (Text,
Word, existing site, etc.) Images
and graphics Design
layout Site map No materials
will be provided Other (please
explain in the text fields below)
Please
estimate the number of pages
you will need.
:
pages
1
- 5 pages
5
- 10 pages
10
- 20 pages
20
- 50 pages
50
- 100 pages
100
- more
When
is your project start date?
:
Immediately
In
two weeks
In
one week
In
two months or longer
Competitive
Analysis & Design
(If
possible, provide examples
of Web sites that you like
and why and the web sites
of your main competitors.)
:
How
did you hear about Mirackle
Web Design?
:
how
did u hear about us
Google
Yahoo
AOL
7Search
MSN
Dmoz
Look
Smart
Ask
Jeeves
Word
of Mouth
Requirements
(Please
describe your requirements
in as much detail as possible,
e.g. if you need a web site
developed then describe its
purpose, audience and any
features like eCommerce or
databased content etc)
:
Choose
payment option?
:
Payment
option
Credit
Card
Demand
Draft
Check
