Lynn Leventhal The Computer Icon - Website Questionnaire

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Thank you for taking the time to fill out our questionnaire.

Section 1 - General Information *Indicates Required Fields

*First Name

*Last Name

Company

Title

Address

City

State

Zip

Telephone

Cell Phone

*Email

Other Information

and Comments

Section 2 - Your New Business

Do you have a domain name? Yes No

If Yes, what is it?

**If No, go to Section 3

If Yes, what company?

Do you have a Web host? Yes No

Section 3 - What Website Name Do You Want? ** If you answered No to a domain name.

Section 4 - What is the Purpose of Your Web Site?

Comments: Please describe what you hope to achieve with your web site:

Informational

Sell Service/s

Sell Product/s

Section 5 - Keywords and Short Phrases to Find You on the Internet

Comments:

10.

Section 6 - Graphic Look and Feel Web sites that you think are most like the 'style' or 'image' you would like.

Section 7 - Logo, Photos, Graphics, Other Artwork, Animation, Sound

Comments: Tell us more about any other artwork or graphics you would like:

Logo

Do you have a logo?

Photos

Do you have photos for your web site?

Graphics

Do you have any graphics for your web site?

Flash

Would you like to have flash on your web site?

Sound

Would you like to have any sound or music on your web site?

If 'No’, would you like us to quote on developing a logo?

If 'Yes', can you provide these by email?

If 'Yes', can you provide these graphics by email?

Section 8 - Web Site Layout and Page Titles

Based on the example above, fill in your Web Page titles in the text boxes below.

More Web Pages

Website Design Questionnaire

TheComputerIcon believes that strong electronic privacy is crucial for the ongoing success of the Internet as a service, commercial, and entertainment medium. We pledge that The Computer Icon will not release your personal data to anyone else without your consent.