Please take this opportunity to help me gather some information about your project. I will return an itemized cost estimate based on your requirements.

Your Privacy is Important: Simply put.. We hate spam too and will not share the information you provide to us with anyone except when necessary to complete the project AND you have been made aware of it.

Only items marked with a red asterisk * are required but please complete all areas of this worksheet that are relevant to your project.

Your Contact Information

Name: *

Phone Number:

Email Address: *

How should we contact you?:

Phone

Email

Your Business or Organization

Business Name: *

Years in Operation: select...Still in development stageLess than 1 yearLonger than 1 year

Business Description: *

URL:

What can we help you with?

Tell me about your project: *

Please be as descriptive as possible.

What is the main objective with this project:

(i.e. Increased sales or visibility, decreased support calls)

Proposed timeframe or launch date:

Project Budget: Less than $1,000$1,000 to $5,000$5,000 to $10,000$10,000 to $20,000Greater than $20,000

This project will be for:

An Existing Website

What are 3 things you don't like about your current website?:

How long ago was your site established?:

How important is it to maintain the colors, branding and imagery on your current site?:

Do you plan to reuse content/imagery from your existing site?:

A New Website

What are the 3 most important things you would like to accomplish with your new site?:

What kinds of content do you already have or plan to develop for the site?:

Do you currently have a logo/branding or imagery for use in your site already in electronic form? (Please Describe):

What does the site need to do?

Site Features:

Shopping cart / Accept Payments

Email Contact Form

Weblog Tool (Blog)

Newsletter Registration

Private Members Area

Photo Gallery

User Registration/Login

Forum / Message Boards

Site Searching

Multiple Language Support

Other Forms or Functionality

(Please Describe):

Post Project Requirements

Once the project is completed I plan to::

Leave the site the way it is until my requirements change

Do my own updates of the information and images on the site

Hire someone to do the updates for me

No idea

Website Hosting:

I have already arranged hosting services for my website

I am interested in having Flipout Hosting host my website

Additional Information

Please provide any additional information that may be helpful in preparing an estimate.:

Verify Your Humanity

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

What code is in the image?: *

Copy the characters (respecting upper/lower case) from the image.