Web Design Intake Form

Web Design Intake Form
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number

Area CodePhone Number
Best way to contact you*
Name of Business
Website
example: www.winnbiz.org
Type of Business
Does your business have a logo?

YesNo
If you answered no, does your business plan on getting a logo within the next year? If so, is this something we can help you with?

YesNo
Do you have photos along with copyrights (photos you have taken or have had designed) that you would like on the website?

YesNo
Choose 3 colors that represent your business & website best.

RedYellowOrangeGreenBluePurplePinkBlackWhiteBrownGrey
Describe your Business: What products/services do you offer?
What are 3 Keywords that best describe your business?
Example: Florist, Florist in Lodi, Red Roses
Do you want to sell services/products directly from your website?

YesNo
Describe yourself: Share your bio
What is the best way to contact you? (How would you like customers to contact you?)

PhoneEmailFacebook MessengerVideo ConferencingWebsite
Do you have an example of a website you like the layout of? If so, please provide it below.
www.winnbizportfolio.org
If you have an existing website, please continue to the next 2 questions. if not, you may skip the next 2 questions.
What do you like about your current website?
What do you strongly dislike about your current website?
What do you want your website to accomplish as it relates to your business?
Do you have a specific need you would like your website to fulfill?
Who is your target audience? (Your Ideal Client)
Should be Empty: