1	[Question Title] Name Company Address 1 Address 2 City/Town State/Province Zip/Postal Code Country Email Address

2	Do you have an existing website? Yes No

3	If yes what is the URL, website address

4	What is the main purpose of your website?  (check all that apply) Sell A Product Sell A Service Market my Business Generate Leads Provide Support for New/Existing Customers Provide Information for New/Existing Customers Other, please specify

5	Will you be selling products on your website? Yes No Maybe

6	If yes, do you have a merchant account (the ability to accept and process credit cards)?

7	Please rank the importance of the following elements to you: 3   2   1   Design Copywriting Ease of Use Animation Shopping Cart Ability to update the website yourself Going Live with the website

8	How often will you need to update your website? Daily Weekly Monthly Rarely Other, please specify

9	What are 3 websites you would like you site to look like or act like?  (Please provide web addresses): Website 1 Website 2 Website 3

10	What is the main goal of your website?  How will you know whether it is successful or not?

11	How much content do you have prepared for your website? We don't have anything right now. We have a logo or a couple photos, but that's it. We have most of our photos and graphics, but no text. We have most of our text, but no photos or graphics. We have everything ready to go! Other, please specify

12	Do you require OMS (Online Marketing Services).  This is similar to what is known as SEO Search Engine Optimization but with the inclusion of social websites like Facebook, MySpace and Twitter. Yes No, I have a SEO/OMS Company to do that for me Not Sure