Please fill out as much information as possible on this page, as it will assist us in determining your needs, and we can better determine an estimate.

All information will be kept strictly confidential.
Affordable design for your home or business.  

Design Contact

Content Contact

(If Different)
Company Name E-mail Address
Anticipated Site  Page Count
Single Page 2-5 6-10 11-15 16-20 Other
Do you wish to have a domain name Registered  (www.yourname.Com)?  Yes I need a domain name No I have a domain name No I will use name
Please list your top 3 domain name choices in order of preference.
Tell us about your current Internet access and ISP/OSP (Internet service provider).
Providers Name Do they provide you with web hosting space? Personal Business or Personal No hosting
What speed is your current Internet connection?  56K Cable/DSL T1 Other
You anticipate that your site is going to grow? Not at all Slowly Moderately Quickly
  What is the purpose of this site? (Advertising, News, Information, Membership, Sales, etc.)  
Please tell us about your time constraints for this site. 
Start Immediately 1 to 3 Months  3 to 6 Months  6 - 12 Months
More than 12 Months   
What custom graphics will be required (check all that apply)? 
I need a logo designed I have a logo Advertising Graphics 3D Graphics Animated Graphics
Multimedia Graphics ( Java Applets) Other Custom Graphics    
What other special features or formats might you need (check all that may apply)?
Midi Files (music) Wav Files (voice) Custom Flash Shockwave Streaming Audio
Streaming Video Multimedia (movie) Acrobat (PDF) Chat Rooms Custom Java Applets
Bulk E-mail Services Site Search Custom Forms Guest Book Subscription Services
Newsletter Services Digital Certificate Database Frames Site Statistics Reports
  Bulletin Board         Search Engine Submission
  Shopping Cart Secured Server Adult Content Credit Card Transactions
Connectivity to external systems (host/mainframe, reservations, accounting, communications, telephone, etc.)  If yes please describe connectivity issues.
Background Use
one color background background image I don't know what background to use
  (May load a bit slower but could look better)  
Graphics Use
Text only NO images (fastest)
Minimum images(appealing, fast)
Moderate images (more appeal, slower loading)
Lots of images (max appeal to bad if they don't have fast access!) Don't know how many images.
Please provide any other details or special instructions that might help us best serve your goals or customize your site.
Mailing Address Line 2
City State Zip
All trademarks, trade names, service marks and logos referenced herein belong to their respective companies.
copyright © 2012 Romore Associates, All rights reserved.