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| Contact Name |
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| Company Name |
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| City and Province |
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| Phone |
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| Email Address |
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Do you require a new design
redesign
or minor update |
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New Design
Redesign
Update |
If new design, please select
which
type of site would you need of |
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If you chose redesign or
minor updates
what is the location of your current website? |
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| Do you need a domain name? |
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Yes, I need a domain
No, I already have a domain |
Do you currently have a hosting provider?
If yes, Who? |
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Yes
No |
| Do you need site maintenance? |
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Yes
No |
Briefly describe the services
and/or products
you or your organization provides. |
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| Project Time frame |
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| Project Budget |
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Are there any existing
websites that you
would
like to use as a guideline for
your new website? This will help us to understand the
style and
image you would like to project. |
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| How did you hear about Chris Design? |
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A representitive will
reply to your request within
two business days. If
you have any additional
comments that you feel may
be important,
please enter them here. |
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| authorization code |
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