About Us Photo

WEB SERVICES INFORMATION FORM


Please complete the following form.  All fields marked with an asterisks are required fields. Once the form has been completed, please press the "SUBMIT " , which will send us your request for web services.  We will provide you with a a cost estimate within 48 hours of  receiving your request.  Be sure to print a copy of your proposal, and thank you for the opportunity to quote your project !

(We have links from certain key terms in this form to our keyword definition listing to assist you.  Just click on the
term to get the definition.)
 

Client Information Name (required)                                        Address
  
City                                          State                      ZipCode              Work Phone
                                     
Mobile Phone                               Fax Number
                            

Email Address (required)
 


 
Domain Name Registration

Need a New Domain Name 
                       suggested names:    

Already Have A Domain Name    
Change Domain Name Characteristics
                 CURRENT DOMAIN NAME:  
                      
                 CURRENT  REGISTRAR
                            networksolutions/verisign  tucows  register.com
                     whois.com GoDaddy.com unknown other :

                                                  (To identify your registrar, fill in the CURRENT DOMAIN NAME box & click GO  
                                                    then copy the value of the Registrar field in popup window to OTHER box above)     


Website Hosting
Need New Website Hosting
Transfer from Current Host to FX-Design
 Hosting Service Not Required at this time
 Keep Current Website Host
                   current website host company:
      
                                              (To identify your current host, fill in the CURRENT DOMAIN NAME box & click GO  
                                                  then copy the value of the NameServer1 field in popup window to box above) 

 


 
Website Development
Need A New Website Developed
 Do Not Need Website Development at this time
 Already have a website development company
           current website development company:

If you need a new website, check off the items you may want on this website:
           basic website - home page,  2 information pages and contact us page
           advanced website - 5 or more pages, advanced features, interactive site.
           custom graphics - artwork that is not currently available to you.
           banner ads for advertising specials
           forms for collecting information from prospective clients (like this one)
           shopping cart for selling products
           online credit card/paypal validation and transactions
           mailing lists with online subscribe and unsubscribe functions
           multiple domain names pointing to the same primary website
           counters for identifying number of visitors to your site
           file upload and download functions for allowing customers to send/receive files with you
           digital photography for new photos
           scan existing photographs or images
           secure site functions (required for online credit card processing)
           POP email accounts (accounts that you can access directly from MS Outlook Express)
                     specify quantity
           auto-forwarding email accounts (forward to your current personal email accounts)
                     specify quantity
           Flash animation - lead page
           maps
           prepare website to run on local laptop for presentations
           other - please specify :
      

 
Website Maintenance
Need Website Maintenance
 Do Not Need Website Maintenance at this time
 Already have a website maintenance company
           current website maintenance company:

If you need a website maintenance, tell us how often and what type of information:

           photos
           catalog updates
           real estate listings
           product pricing updates

          specify quantity of updates:
 

 
Search Engine Registration
Need Search Engine Registration services
 Renew existing Search Engine Registration services
 Do Not Need Search Engine Registration services at this time

      Select a Registration Package: (includes meta-tag creation in your main webpage)
    
          Top 5 Search Engines - one time submission with request to revisit by search engines
 

          Top 20 Search Engines - one time submission with request to revisit by search engines
 


         Over 100 Search Engines - utilizes a service with annual renewal
         Only Create Meta-tags for website   CHECK YOUR CURRENT METATAGS
 


 
Training
Website Maintenance Training (including shopping cart maintenance)
 Computer Software Training (MS Word/Excel/Powerpoint/Access)
 Website Development Training
 No Training Required at this time
      If Training Required :
                Training at customer location
                Training at FX-Design office or other location
      If Training Required:
                 specify number of students:
 

Notes Please include any notes that may be relevant to your request: