First Name *

Last Name *

E-mail *

Phone *

Company Name *

Your company’s name as it should appear on your website.

Tagline / Slogan

What is your tagline, slogan or similar.

Website E-mail Address

The primary e-mail address for the website.

Website Phone Number

The primary phone number as it should appear on the website.

Mobile Number

The primary mobile number as it should appear on the website.

Street Address

The primary address that should appear on the website.

City

State

ZIP Code

What is the purpose of this website? *

Explain your products and services Sell products (E-commerce) Create a membership or subscription/community based site Provide your customers with information on a certain subject Deliver news or calendar of events Create a blog that addresses specific topics or interests Provide support for current clients

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

What primary content do you want on your home page?

Do you currently have any social media accounts set up?

Do you have an email marketing account?

Mailchimp Constant Contact Other

Do you currently have a corporate email account using your domain?

Google Apps Office 365 Other

What is the main service you offer?

What is your 30-second elevator pitch?

Describe your services and/or products

What are the specific “buckets” within your company which you offer.

Any other industry specific features you want on the home page?

What pages do you think you want/need on your site?

One per line.

Who are your main competitors?

Are there any additional features that you would like for your site?

Accounting systems, database, membership options, community options. Please be as specific and detailed as possible.

What’s ahead?

Are there any future goals you have, or things that you would like to add in the future? Please be as specific and detailed as possible.