MERL Web Designs Logo                            Web Site Design
Detailed Request Form

 

 

The form below is used to determine the approximate cost of the Web site needed to promote your business or non-profit organization. The information you provide us will be held in the strictest confidence. None of the information you provide will be used for marketing purposes, or provided to any other organization without your written consent. If you would rather talk to us feel free to call us at (928) 342-5400 or send us a FAX at (928) 342-7396 during our normal business hours Mon - Fri. 9:00 AM - 6:00 PM MST or email us.

 

Submit the information below and we will contact you shortly.

 

Company Name:
City:
State/Province:
Country if outside USA:
Your Name, Title (required):
E-mail (required):
Phone Number:

What design and marketing services do you want?
    Design new site. Number of pages
    Re-design current site
    Promote and market site

Domain Registration and Hosting
Current Domain Name (URL):  

Do you need a domain name registered?
     Yes      No

Do you want hosting set up for you?
     Yes       No

Purpose of your site:
    Sell products/services online. Approximate #
    Marketing tool to get new customers/clients
    Information resource for current customers
    Provide customer service
        What type of service?  

Size of your company:
    Small business
    Medium business
    Large business

What does your business do? What are your goals for the site?

 
What other sites do you like that are similar to the type of design you want? What do you like about them?
What you DO NOT want on your site?


What graphics, photos and other art do you have?
What art do you need designed?


Will you write the text or will we write it?
    I write it
    You write it

Other information:


What promotion services would you like?
Optimize pages so good indexing by engines
     Submit site to engines and directories
Improve link popularity
Recommend paid submission and Pay-per-click programs

What other marketing services would you like?


What is your Web site design budget?
(All monitary values are in US Dollars)
 Less than $500
$501 to $750
$751 than $1,000
$1,001 to $1,250
$1,251 to $1,500
Greater than $1,500
Or fill in your budget $: 

What is your annual marketing budget for this project?
(All monitary values are in US Dollars)
$300 to $425
$426 to $550
$551 to $750
$751 to $1,025
Greater than $1,025
Or fill in your budget $: 

Do you have a deadline when the site must be completed?
If yes, when:

Questions or other information we need.

I have read and agree with the Privacy Policy.    Yes 



 

***********************************************************