Website Intake form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Do you have a website?* This field is required.

YESNO

6

What is the website about?

7

What changes do you want made?

8

Do you operate the website?

Yes, (by myself/with my team)

No, an agency/designer does

9

Link to website

10

How many pages is your current site?

1 page only

5 pages (not counting CMS pages)

7 pages (not counting CMS pages)

10 plus pages (not counting CMS pages)

I don't know

11

Do you have a domain?* This field is required.

Yes I have a domain, I have access/control over it

Yes I have a domain, but an agency/designer has access/control over it

I do not have a domain

13

Describe the website you want made

14

How many pages do you require?

1 page only (landing)

5 pages

7 pages

10 plus pages

15

List the pages and features you want

16

Note, since you selected "1 page only (landing)" the design will be either "bento" single page or a 5 segment single page (who, what when where, why) type design. Whichever design is applicable to the project.

17

What features you want on a single page site?

19

Require Maintenance for your website after completion?* This field is required.

1 Month after completion

6 Months after completion

1 Year after completion

None

20

Main Color for the Website?

21

Secondary Color for the Website?

22

Third Color for the Website?

23

Additional information you would like to share for your project?

24

Estimated Cost of The Project in USD Subject to change