Contact Name * Company or Product Name * Email Address * Phone Number * Preferred Method Of Contact Phone Email Text Message Postal Mail Best Time Of Day To Contact Would you like Web design and/or hosting services? Please select an option Design only of an entirely new website Re-design only of an existing website Maintenance of an existing website Web Updates Only - Pay As You Go - $45 per/hr Web Hosting Only - $12 per/month Domain Registration only - $15 per/ year Domain Transfer only Email Set Up (up to 5 email addresses) Design & Hosting of an entirely new website Design & Hosting Transfer of an Existing website Other (please specify below) Which capabilities do you require? Please select (CTRL& left mousebutton) Full E-commerce Site Shopping Cart Functions (eg Paypal) Flash Header Only Full Flash Site Flash Animations Mouseovers Copywriting ($75/hr) Copyediting ($50/hr) Database Design Login Features Additional Pages (custom design) - $150 each Additonal Pages (from template) - $90 each Social Networking Site Other (Please specify below) When would you like the website design work started? Please select an option ASAP One Month Two Months Three Months or more Other (please specify below) How soon do you require your project to be completed? Please select an option Within 4 weeks Within 2 months 2-6 months Other (please specify below) Don't know, please advise Type of Web Updates/Maintenance required Please select an option Web Updates (Pay As You Go) - $45 per/hr Web Maintenance Package (1 hr/month) - $35/mo Web Maintenance Package (2 hrs/month) - $60/mo Web Maintenance Package (5 hrs/month) - $150/mo Web Maintenance Package (10 hrs/month) - $350/mo Web Maintenance Package (15 hrs/month) - $550/mo Web Maintenance Package (20 hrs/month) - $750/mo Other (please specify below) Not sure (please recommend option/package) Will you need a logo designed?
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Will You Require Web Hosting With Us? Please select an option Website Hosting (Monthly) - credit card only Website Hosting (Quarterly) - credit/checks accepted Website Hosting (Annual) - credit card/checks No thanks, not at this time Not sure, please advise Other Information Upload File Subscribe Newsletter (Special Offers and Discounts)? *
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