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10
Questions
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1
What type of website is it?
*
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Business
E-commerce / Online store
Non-profit
Personal website
Other
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2
Which of these best describes your Web Design requirement?
*
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Create a new website
Overhaul of my website
Minor changes to my website
Other
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3
What are the objectives of your website?
*
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Online presence
To Sell and take payments online
To Sell and take payments offline
Provide information to the public
To book Appointments
Other
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4
How soon would you like the project to begin?
*
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ASAP
In the next few weeks
In the next month
In the next 2-3 months
I'm not sure
Other
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5
What is the deadline for this project?
*
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I'm not sure
Less than 1 month
Up to 3 months
Other
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6
What is your estimated budget for this project?
*
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$500 - $999
$1,000 - $1,999
$2,000 - $2,999
$3,000 - $4,999
$5,000 - $9,999
&10000 +
Other
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7
Email
*
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What email address would you like demo sent to?
john@mail.com
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8
What is your phone number?
*
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We will be able to contact you directly to find out more about your request.
Please enter a valid phone number.
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9
Please tell us your name:
*
This field is required.
John
Smith
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10
Please choose website features
Select Yes if you want to include that feature on the website
Yes
No
Yes
No
Yes
No
Yes
No
Appointment booking system
Contact form
Capture email
Calendar to check event
Appointment booking system
Contact form
Capture email
Calendar to check event
Yes
No
Yes
No
Yes
No
Yes
No
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