Web Site Design / SEO Redesign

Interested in a new website design or re-design of an existing site?
Please enter your details below and we will contact you to find out your needs and provide a quote for your project.

Your Name
Business Name
Address
Address2
City	State     Zip
Email
Daytime Phone
Type of Business

Do you currently have a web site?
Yes  No

(If yes) What is the address (URL) for your web site?

Please indicate your level of comfort with computers:

Very comfortable - I do word processing or spreadsheets, and can crop, resize and reduce the resolution of my images with ease.
Fairly comfortable - I know how to use my e-mail and surf the internet with ease.
Not yet feeling confident in my computer skills. But working on it!

Please describe your business and what it does:

Please tell us what you would like your web site to do for your business:

How often would you like your web site content to be updated?
Daily
Weekly
Monthly
Every three months 
Every six months
Yearly


Do you have or wish to obtain a new domain name for your web site?
(ie www.yourbusiness.com )
Yes No

Will you require web site hosting?
(ie. web site files to reside on our internet server)
Yes No

Do you have access to a scanner, or would you prefer to send your photos to us by mail for scanning?
Have scanner - will e-mail images/photos
Will mail images for scanning

Does your business have a logo, or will you need to have one created?
Have Logo   Need Logo

Would you like to have business cards or stationery designed to match your web site?
Yes No

Do you sell a product or products that you want to be able to offer for sale online?
Yes No

If yes, how many different items will you have?

If yes, do you currently have an e-commerce solution or merchant account?
(ie. the ability to accept credit cards)
Yes No

Would you like to be able to make your own changes to your web site?
Yes No

How quickly do you wish to have your web site up and running?
  1 week RUSH     2 weeks     3 weeks     1 month     2-3 months

 

Virile Marketing Inc. does not collect, share, or sell personal information from its Web site visitors without their consent.
As a professional SEO firm, any information gathered that comes from you voluntarily via our online forms is not shared with or sold to outside interests...ever.