Web Design Application Form

Please make sure you fill out the form with accurate and updated information. Free quote, no obligation.

Contact Information
First Name:
Last Name:
Email:
Password:
(You may be asked to login if invited to see the pre-design)
Address:
City:
State:
Zip Code:
Country:
Home Number:
Work Number:
Fax Number:
URL if exists:

The Website Information

  • Who will be the owner of Web site?
    • Individual
    Business

  • What type of services are you looking for?
    • Design of a new site
    Just one-time upgrade to an existing site
    Work as a webmaster, or maintenance
    Add web component to Web site
    If other, please specify:    

  • What is the purpose of Web site? (check all that apply)
    • Establish an online presence
    Provide information
    Provide customer service including online sale
    Offer a virtual community
    Intranet/Extranet
    If not listed above, please specify:    

  • If designing a new Web site, what will you be providing to the designer? (check all that apply)
    • Content/text
    Images/graphics
    Page layout/template
    Site map
    Logo
    Not sure

  • Approximately how many Web pages do you need?
    • 1-19
    20-39
    40-59
    60-99
    100+

  • What kind of technologies you would like to use in your Web site?
    • Not sure
    Applet
    CCS, SSI, DOM, etc.
    Client side scripting
    Limited CGI like Guestbook, mailing list, Reader feedback, etc.

  • Who will do your site updates?
    • In house or your own company
    JavaCamp or Web designer
    A third firm
    Not sure

  • When would you like the project to start?
    • As soon as possible
    In 2 weeks
    In one month
    In two months
    Not sure

  • Do you want database design?     Yes No

  • If you hope your Web site would look like some sites, please list the address of those sites: such as www.javacamp.org.

  • Please tell us more about your project if neccessary, such as any additional requirements like streaming audio/video, database, secure pages, etc.

    • After submission, you will get quote immediately.