Web Design Information Request Form

Please answer the following questions so that we will have all of the necessary information prior to your free initial consultation call. If you have any questions feel free to e-mail us at info@jollyrogergraphix.com

Jolly Roger Graphix & Web Design

CONTACT INFORMATION
First Name
Last Name
Email
Phone
Cell Phone
Fax
Address
City
State
Zip
DESIGN INFORMATION
I would like to:	Create a new site Redesign an existing site
Do you own a domain name?	Yes No
URL of site to redesign:
Describe what you want changed:
Do you have existing content?	Logo Text Graphics
Is this content available:	Digitally Printed
Estimate number of pages in site:
Estimate number of graphics items:
Describe the tone, style, and color scheme desired for the site:	Contemporary, Elegant, Informative, Colors desired.
Projected time frame:	Start End
Are there existing websites that emulate your vision?	1 2 3
Budgeted price range:
Comments, Special Instructions or Concerns:
Where did you hear about us?	Other

Thank you