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Your Details
Name:
Company:
Type of Business:
Current Website if any:  
Address:  
Country:  
Telephone:   required
E-mail:   required
How did you find us?  
If Search Engine which one?  
About Your Proposed Site
How many pages do you think your new site will need?  
Have you registered a top level Domain Name? Yes No
Do you have a preferred colour scheme for the new site?
Please describe the proposed site Content:  
Please indicate if you require any of the following:    
Order Form:  
Order Form (secure):  
Shopping Basket (secure):  
If shopping basket required - number of products:  
Are your products in a database? If so please specify...  
Other Information Which Would Be Helpful
Do you Require Internet Marketing/Promotion?   Yes No
Please give deadline for site completion if any:  
Please give target budget for the Website if known:  
     
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