Check appropriate box(es):

New Website Design
Website Re-Design
Database Design
Special Programming
Graphic Design

Answer questions as it relates to your website request

1. Do you currently have a website? Yes No

2. Do you know anyone who has a website? Yes No

3. How many websites will you need designed?

4. What audience are you hoping to target?

5. How many pages will you need?

6. Do you have business or organization colors or preferred colors to be used?

7. Do you have a logo? Yes No

8. Is it formatted for the web? (jpg or gif low resolution) Yes No

9. If you don't have a logo, would you like to have one designed? Yes No

10. Will photos be used? Yes No

11. Will you provide us with photos Yes No

12.Will we furnish the photos? Yes No

13. How many?

14. In what format will you provide the photos? prints scans

15. Will the photos need re-sizing or touch-up? Yes No

16.Will you need special graphics designed for your website? Yes No

If yes describe

17.Will you need a database? Yes No

If yes describe your needs.

18. How often will you need updates?

Daily Weekly Monthly Annually Not Sure

19. Have you visited sites that appeal to you? Yes No

If so, what are the URLs/web addresses?
(example: www.yahoo.com)

1.
2.
3.

20. Choose from one of our samples below

None sample 01 sample 02 sample 03 sample 04 sample 05 sample 06 sample 07 sample 08 sample 09 sample 10

21. Provide contact person

Submit completed form and receive a free consultation
Thank you for choosing Brinkley Solutions for your website needs