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First
Name *
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Last
name *
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Organization
Name
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Address
1
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Address
2
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City
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State/Province
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Zip
/ postal code
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Country
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Phone
Number *
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(please
include area code)
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Fax
number (optional)
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Contact
E-mail *
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Web
Site Address ( if you do not have say None )
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Pl
contact me via:
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New
web site design
Pl
give us little bit more information about your business . Also give
us four to five web sites you liked the most.
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Redesign
of the current Web site Pl tell us what you do n;t like about your
web site and what you do like.
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Other
Information
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Please
select features and services you will require:
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Logo
Design
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Flash
Animation/Presentation/Intro
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Interactive
Features (Form Mail)
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Site
Maintenance (after completion of project)
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Banner
Design
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Database
Programming
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Custom
Web Programming
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HTML
Newsletters
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Custom
Script Design (cgi, java, perl, etc)
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mpeg
video streaming
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Flash
Interactive Games
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Custom
Software Development
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Shopping
Cart (Please specify amount of products)
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Additional
Info
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How
soon do you need to start the project?: *
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Please
describe the purpose of the Web site and provide any other
information that you feel will be helpful: *
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Did
anyone refer you? If yes, who?
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