Company Name:

First Name:

Last Name:

Address 1:

Address 2:

City:

State:

Zip:

Country:

Telephone:

E-Mail Address:

State the purpose for having a World Wide Web site:

To establish a presence on the Internet and the World Wide Web.

To advertise product information and price lists to customers.

To sell products directly using credit card information over the Internet

To have potential customers contact you by phone or mail.

Other:

Do you already have a domain name?

Yes

No

Desired Domain Name:
(Example: companyname.com)

Please enter your second choice:
(Example: companyname.com)

Page Title (To appear at the top of the Web browser and will show on listing by web search engines)

Page Description (200 characters or less to be used by search engines)

Page Keywords which people might use to find your company product or service (separate words with commas)

Top of page Navigation Bar?

Yes No

Side of page Navigation Bar?

Yes No

Bottom of page Navigation Bar?

Yes No

E-Mail response link(s)?

Yes No

Copyright at bottom of pages?

Yes No

Last modified date at bottom of pages?

Yes No

Estimated number of pages:

Names of sections:
(eg. Services, Contact us, Guest book, Home)

Graphic(s):

Yes No

Estimated #:

Standard company information:

Yes No

Copyright/Disclaimer on each page:

Yes No

May we include a link to "Designed by B2B Solutions"?
Note: If you include this you will receive a $10 discount

Yes No

Other:

Desired Text Color:

Select color from list: Black Custom Navy Blue Red Aqua Green Olive Maroon Purple Silver Teal

Desired font face:

Select font from list: Arial Avant Garde Bookman Century Schoolbook Courier New Future Garamond Times New Roman Verdana

Size of normal text type: (relative to the user's settings in browser)

Select default font size: 1 (8 pt.) 2 (10 pt.) 3 (12 pt.) 4 (14 pt.)

Desired Background Color or Texture:
(A white background with a band of color on the left margin offers the best readability and contrast)

Select color or texture for background: White w/ Colored Stripe on left Gray Marbled Gray Textured Blue Marbled Blue Textured Brown Marbled Brown Textured Other (optional)

Background Image

Do you already have a Company Logo?

Yes No

If No, would you like us to design you one?

Yes No

Do you have Photos already in PC format that you would like to use?

Yes No

Estimated #

Other Graphic Images/Clip art?

Yes No

Estimated #

Need Scanning of Images?

Yes No

Estimated #

Need custom designed graphics?

Yes No

Estimated #

Animated GIF's

Yes No

Estimated #

Sound (MIDI,WAV)

Yes No

Estimated #

Other

Guest book

Yes No

Customer Feedback/Comments

Yes No

On-line Orders

Yes No

Other (If you want to receive credit card information, you'll need an SSL-secure server or if you have an account with us you can use ours )

(Please list any other special needs)


CGI, JAVA, etc.:

(Please list any needs for custom programming)