Website order Form

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Web site order form

Name *

First

Last

Email *

Phone *

Company

Type of business *

Site completion deadline

What is your budget?

Do you already own a domain name?

What is your domain name?

Type of website you need? *

What color choices will you want for your site theme?

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What are you offering? Make a list of all the things you think that you'll need.

Additional services

What action(s) should the user perform when visiting your site?

Additional comment / features. Please be as specific and detailed as possible.